Import Warren Carter top-scored with 30 points and fellow American Brandon Bowdry added 18 points despite battling foul trouble most of the game.
Player-coach Mark Dickel equalled his own franchise record of 14 assists, and Sam King returned to form with 11 points and five rebounds from the bench.
The win has come at a huge cost for the Nuggets, though. Starting guard Micah Lepaio was injured during the warm-up and took no part in the match, and former Tall Black Brendon Polyblank suffered a suspected broken nose.
Assistant coach Carl Dickel said the Nuggets might have to send for replacements for tonight's match against Giants in Nelson.
Mountain Airs guard Brad Anderson led the scoring for his side with 28 points and centre Suleiman Braimoh had a double-double of 26 points and 11 rebounds. He had an opportunity to force overtime in the final moments of the match but came up short.
Bowdry put the game out of reach with two from two from the free throw line before Braimoh added a late three-pointer to cut the victory margin to one point.
Bowdry, though, got into early foul trouble. Carter stepped up in his absence with an 11-point opening quarter. Seven of those points came in the final 90 seconds of the period.
Anderson was proving deadly from range and had amassed 21 points on 7-10 shooting by halftime. Mountain Airs captain Aaron Bailey-Nowell dominated the boards with 15 rebounds. Shamefully, the Nuggets had claimed just 10 rebounds in the opening 20 minutes.
Both teams were missing regular starters. Taranaki axed import Adrian Oliver earlier in the week and the Nuggets had to start with Tony Tolovae due to Lepaio's injury and the unavailability of back-up guard Olly Smith.
Bowdry picked up his fourth foul with 90 seconds remaining in the third quarter. And with Carter also sitting on three fouls, the Nuggets went into the final period with trepidation.
The visiting side trailed by just three points but took the lead with six minutes remaining, thanks to a three-pointer from Dickel. Neither side was letting go of victory and a repeat of last year's historic quadruple overtime thriller in New Plymouth threatened.
With 45 seconds left, the sides were tied 86-86. The Nuggets worked the ball to Carter who netted two points. Taranaki replied by working the ball to Braimoh but the big man missed.
NBL: The scores
Otago Nuggets ... 90
Warren Carter 30, Brandon Bowdry 18
Taranaki Mountain Airs ... 89
Brad Anderson 28, Suleiman Braimoh 26
Quarter scores: 27-28, 43-49, 67-70
