New England enters this game in top form, while Buffalo still profiles as a playoff-level team with a strong defense. That mix pushes these picks toward a tight game, limited scoring, and a heavy workload for the Bills’ running game. Our Bills vs Patriots Predictions focus on the spread, the total, and two player props tied to game flow rather than explosive scoring.
*These suggestions are based on football game analysis, but sports results remain unpredictable.
Patriots to Cover the Spread +1.5
New England comes into Week 15 on a 10-game winning streak and holds an 11-2 record. They lead the AFC East and continue to play balanced football. The Patriots average 28.9 points per game and nearly 158 rushing yards per contest, which gives them control over tempo.
Buffalo sits at 9-4 and has been less consistent over the last five games. The Bills’ defense remains strong, but several key players are dealing with injuries or limited practice participation. In a matchup that already played out as a three-point game earlier this season, taking the points with the hotter team makes sense. Patriots +1.5 allows room for another close finish.
Under 49.5 Total Points
Both defenses set the tone for this total. New England allows just 18.5 points per game and limits opponents through disciplined coverage and controlled possessions. Buffalo gives up only 171.8 passing yards per game, which ranks among the league’s best marks.
The first meeting ended with 43 total points, and this rematch profiles similarly. New England prefers to lean on the run, while Buffalo’s defense funnels opponents away from explosive passing plays. That combination points toward sustained drives, clock usage, and fewer quick scores. Under 49.5 fits the expected pace and style.
James Cook Over 80.5 Rushing Yards
This prop aligns with how Buffalo can best attack this matchup. The Patriots allow fewer points, but their defensive injuries at linebacker create an opportunity for a run-focused approach. Sustained rushing success also helps Buffalo avoid New England’s defensive strengths.
A heavier rushing workload shortens the game and complements the Under. If the Bills remain competitive throughout, Cook should see enough volume to push past this number without requiring big plays.
James Cook Anytime TD
This pick pairs naturally with the rushing yard prop. If Buffalo reaches the red zone, a run-based finish becomes the safest option against a disciplined Patriots defense. Touchdowns may be limited overall, which increases the value of targeting a primary rushing option near the goal line.
In a game projected to stay close, one rushing touchdown can swing outcomes without inflating the total score.
Bills vs. Patriots Game Overview – NFL Week 15 Sunday
New England enters this game riding a dominant stretch, with five straight wins and a firm grip on the AFC East. Their offense remains balanced, and their defense allows fewer than 19 points per game. Even with injuries to Terrell Jennings and Harold Landry, the Patriots have maintained structure and efficiency.
Buffalo brings a strong pass defense and averages 27.0 points per game, but recent form has been uneven. Several starters on both sides of the ball have been limited in practice, which adds uncertainty. The Patriots also hold a clear edge in recent head-to-head meetings, including a win earlier this season. All signs point to a controlled, physical game where margins stay tight and every possession matters.
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- Source: https://sportshandle.com/bills-vs-patriots-predictions-and-picks-spread-totals-props-nfl-week-15/