Gone are the days of the two clubs battling for the Scudetto, instead finding themselves marooned in mid-table and adrift of the top five with eight games to go.
A point separates them ahead of the derby, with Milan just ahead of Roberto Mancini's side thanks to a three-match unbeaten run – slightly lifting the pressure on Filippo Inzaghi.
Inter have failed to find any consistency since Mancini arrived at the club in November – his first game was the reverse fixture that ended 2-2 – and defeat this weekend could see them slip into the bottom half of the table.
One of Mancini's January signings, Xherdan Shaqiri, is not concerned about their plight, though, and insists morale is high in the dressing room.
"There is a great atmosphere; special, positive," he said. "The tension is rising, there is also a special atmosphere in the city.
"We know it's an important match and we have a great desire to win. The stadium will be full and it will be the first time for me. I expect a fantastic evening, we want to give satisfaction to our fans by beating Milan.
"We must enter the field with the right motivation, respect and instilling fear in opponents."
Milan may have the edge in the league table, but that does not take away from the fact that they too are under scrutiny as they attempt to salvage a dismal season.
Inzaghi was installed as head coach to give the club new hope after last season's disappointment, but he has failed to have the desired impact.
Still there is the hope of claiming a UEFA Europa League spot, with a seven-point gap to overcome and Giacomo Bonaventura believes they have the quality within the squad to achieve that.
"We know that by winning the derby we'll give a bit more enthusiasm to the supporters and to ourselves," the midfielder said.
"We certainly have had a rough season in terms of the results and the mood around us. Earning three points on Sunday could boost us into a strong final rush.
"It feels strange [that] a few years ago, the game was played with Inter and Milan in higher positions in the league.
"But this is our context for this year. It's still an important game for us, one that we must prepare for appropriately."
Milan have been boosted by Mattia Destro and Keisuke Honda returning to training on Friday, while Inter will have to do without Fredy Guarin and Marcelo Brozovic due to suspension.
