Predicting How Patriots Look Against Bills in Week 4: A Must-Win Game?

The New England Patriots, just like last season, haven't gotten off to a fast start. They're sitting at 1-2, behind the Buffalo Bills once again in the division standings and don't look like a complete football team.

But last year, that all changed after a primetime win in Buffalo. Could that be the same for this year's team? The Patriots head to Western New York for their first AFC East matchup of the season following three-straight poor performances. Sunday is a big opportunity to bounce back.

"More points, less negative plays," Mike Vrabel said Wednesday. "Again, I've been in this a long time — this is about players and not plays. That means that there's no magic formula, right? It's about execution, it's about playing with great speed, with great aggressiveness, being decisive."

Ahead of Week 4, Patriots On SI beat reporters Ethan Hurwitz and Zac Ventola break down how the game will unfold, which players will be x-factors and predict a final score. Who do you think is right?

Hurwitz: Will Offense Finally, Finally, Shine?

Dec 14, 2025; Foxborough, Massachusetts, USA; New England Patriots running back Treveyon Henderson (32) scores a touchdown against the Buffalo Bills during the first half at Gillette Stadium. Mandatory Credit: Brian Fluharty-Imagn Images | IMAGN IMAGES via Reuters Connect

It's no secret that this offense is among the league's worst right now. Drake Maye has turned the ball over seven times. The wide receivers and tight ends haven't been able to get a lot of separation in their routes and the running game doesn't look all there. Couple that with the consistent injuries along the offensive line, and this group is struggling for anything positive.

At some point, that will change. This offense, a group that went to the Super Bowl a season ago, won't look this dreadful for 14 more games. That's just impossible to imagine. But it's going to have to break out at some point, and it's hard to imagine that happens against the undefeated Bills in front of their rowdy fanbase. It's not truly a must-win game, but it's a week that requires a must-improve offense.

X-Factor: RB TreVeyon Henderson

Henderson missed the Patriots' first game of the season with an ankle injury. Since then, he's only gotten 25 touches (24 rushes, one reception). Sure, he had the 39-yard touchdown in Week 2's win, but the second-year back hasn't been used that often. Maybe that's part of the reason why that side of the ball doesn't look explosive. The Patriots need to figure out how to get the ball into Henderson's hands early and often.

Final Score Prediction: Bills 27, Patriots 13

Until I see the Patriots actually look improved on offense, it's hard to predict a win for this team — at least against the cream of the AFC crop. Josh Allen and this Bills offense looks unstoppable, and the Patriots defense didn't get a single stop in the red zone. Unless Maye has a similar outcome to last year's game, I can't see the Patriots evening their record back to .500 just yet.

Ventola: Prove Me Wrong

Oct 5, 2025; Orchard Park, New York, USA; Buffalo Bills tight end Dalton Kincaid (86) makes a catch against New England Patriots cornerback Christian Gonzalez (0) during the first half at Highmark Stadium. Mandatory Credit: Gregory Fisher-Imagn Images | IMAGN IMAGES via Reuters Connect

A week ago, I mentioned how I cannot justifiably pick the Patriots to beat a playoff-caliber Jaguars squad until New England fixes its biggest errors. Fast-forward seven days and that exact reasoning still applies. After another multi-turnover game for Maye, plus injuries to defensive starters Christian Gonzalez and Christian Barmore, it feels unjust to pick the Patriots to win until they prove they can play high-quality football.

If Maye can turn the tides and return to his 2025 self, this game could play out in New England’s favor. But until the third-year quarterback stops seeing ghosts, the Patriots will continue to struggle.

X-Factor: DT Milton Williams

Going up against quarterback Josh Allen is a tall task on its own. That only becomes harder when he has 2025 rushing yards leader James Cook by his side. Williams will need to play a substantial role in slowing down that tandem, especially with Barmore unavailable with his shoulder injury. Not to mention, Williams is yet to record his first sack of this season. Doing so on Sunday, potentially multiple times, would be a saving-grace for the Patriots.

Final Score Prediction: Bills 34, Patriots 17

Up against an undefeated Buffalo squad, it feels near-impossible for New England to look remotely competitive in this battle. Maye will have to play near-perfect football to give the Patriots any shot at victory. Additionally, New England simply has too many substantial injuries to have a fighting chance. With Gonzalez and Barmore out, plus A.J. Brown and Mike Onwenu on injured reserve, I expect an AFC East blowout on Sunday.

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