The game had been heading for a draw, with City having squandered a two-goal lead after four goals in a mad nine-minute spell midway through the second half.
The hosts had gone ahead in the 56th minute through Samir Nasri and doubled their lead three minutes later courtesy of Joleon Lescott’s bundled effort.
Spurs got themselves right back in it with a Jermain Defoe goal on 60 minutes after a blunder by City defender Stefan Savic followed five minutes later by an exquisite Gareth Bale strike.
The visitors could have grabbed all the points in stoppage time when Defoe went agonisingly wide with a golden opportunity but City made the most of their chance at the other end when Ledley King brought down Balotelli.
The Italian converted calmly to send the packed stadium into raptures as City moved to 54 points from 22 games, with second-placed Manchester United on 48 before their game at Arsenal later in the day. Spurs stay third with 46.
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