The Steelers trailed by 11 points heading into the final quarter at Tennessee's LP Field, but Le'Veon Bell's rushing touchdown and quarterback Ben Roethlisberger's first scoring pass of the match - to Antonio Brown - saw them get back on the winners' list.
Roethlisberger finished with 21 completed passes for 207 yards gained, and also one interception, while Titans playmaker Zach Mettenberger gained 263 yards from 15 completed plays - including two TDs and one interception.
But impressively, running back Bell finished with 204 yards gained from 33 rush attempts in a match-winning cameo.
Pittsburgh were humbled by the New York Jets last time out, and started positively enough in their bid to avoid two straight losses in their strangely competitive AFC North division - which sees all four sides with positive records.
The Steelers were 10 points up after a 49-yard field goal from Shaun Suisham and William Gay's 28-yard interception return TD.
Bishop Sankey rushed nine yards for Tennessee's first score, but the Steelers took a six-point lead to the first break when Suisham slotted a 23-yard field goal.
However, the Steelers' offense went cold in the next two quarters - and the Titans surged to a healthy advantage, with Nate Washington's 80-yard TD combination with Mettenberger a highlight of their charge.
That came after Ryan Succop's 20-yard field goal, and was followed by Mettenberger's four-yard pass to Chase Coffman.
But a final-quarter comeback saw the Steelers clinch a crucial win to their division hopes, and deal the Titans a fourth straight loss to see them fall to 2-8 in the AFC South.