The football rivalry is younger than the rivalry it joined. Sunderland and Newcastle found themselves on opposite sides during the Jacobite risings of the early eighteenth century - Newcastle supporting the Hanoverian King George, Sunderland siding with the Scottish Stuarts. By the time football arrived, the two cities already understood the geography of disagreement. The first meeting between the clubs took place in 1883, and the first competitive fixture was an FA Cup tie in November 1887, won 2-0 by Sunderland over the side that would later become Newcastle United. The 1901 Good Friday encounter at St James' Park was abandoned when up to 120,000 fans squeezed into a ground built for 30,000, with rioting and injuries following. The crowd discovered, in other words, that this was going to be that kind of fixture.

The rivalry's modern rhythm has been one of long absences punctuated by intense bursts. After Sunderland's 1999 win at St James' Park - manager Ruud Gullit notoriously dropping Alan Shearer to the bench, and resigning when Sunderland won 2-1 - the fixture became a fixture again. Between October 2013 and April 2015 Sunderland won six derbies in a row, a club record. Paolo Di Canio's 3-0 away win in April 2013 - Sessegnon, Adam Johnson and David Vaughan scoring - was their first away victory in thirteen years. Then Sunderland were relegated to the third tier in 2018, and the derby disappeared for years. Newcastle won a 3-0 FA Cup tie at the Stadium of Light on 6 January 2024, their first away derby win since 2011, in front of a crowd that had been waiting nearly a decade for it.

Sometimes the derby has carried genuine violence. In March 2002, the Seaburn Casuals from Sunderland fought hooligans from the Newcastle Gremlins near the North Shields ferry terminal in a pre-arranged clash that police described as some of the worst football-related fighting ever seen in the United Kingdom. The leaders of both firms were jailed for four years; twenty-eight others received various terms, after police read the messages they had sent on their mobile phones during the day. A year later, ninety-five fans were arrested in Sunderland city centre before an England qualifier against Turkey. Most derbies are not like this, but enough of them have been that Northumbria Police treat the fixture as a major operation, and most fans treat the day as one to plan around.

On 24 May 2025, Sunderland beat Sheffield United 2-1 at Wembley in the Championship play-off final to win promotion to the Premier League for the first time since 2017. The Tyne-Wear derby was back in the top flight for the first time since 2015-16. The first Premier League fixture between the two came on 14 December 2025, at the Stadium of Light: Sunderland won 1-0, Newcastle striker Nick Woltemade scoring an own goal in front of a home crowd that had been waiting a long time for an own goal of exactly that kind. Earlier in the new era, on 13 October 2024 Sunderland Women had hosted Newcastle United Women at the Stadium of Light - the first women's derby - drawing 15,387 fans, a Women's Championship attendance record. Twelve miles between the cities, and ninety minutes of football continues to compress the difference into something visible.