Novak Djokovic needed five match points and nearly four hours to pull off a gritty victory over Carlos Alcaraz and claim a third ATP Cincinnati Open title.

A titanic struggle between the world’s top two players saw Djokovic — who looked out on his feet in the second set — save a match point before coming through on his own fifth match point for a 5-7, 7-6 (9/7), 7-6 (7/4) triumph.

“It’s crazy, I don’t know what I can say,” said 23-time Grand Slam champion Djokovic, who was seen by the doctors early in the second set for heat illness in a battle that lasted three hours and 44 minutes.

“It’s tough to describe. It was the toughest I’ve ever played in my life. “From start to finish we both went through highs, lows, incredible points, bad games, heatstroke, comebacks.

“Overall this was the toughest and most exciting match I’ve ever been a part of. “It’s matches like these that I continue to work for.”

It was another epic chapter to the budding rivalry between 20-year-old top-ranked Alcaraz and the 36-year-old Serb star, who avenged his loss to the Spaniard in a five-set Wimbledon final last month.

The two — who have traded the number one ranking six times this year — are now level on two wins apiece in their head-to-head rivalry.

Djokovic, who earned a record-extending 39th victory at the elite Masters 1000 level, secured the first break of the opening set, sending Alcaraz sprawling as broke to love for a 4-2 lead.

A few minutes later, however, the Spaniard returned the favor. Alcaraz then broke for a 6-5 lead then held to take the set before Djokovic left the court for a seven-minute change of clothes.

Djokovic, clearly affected by the hot, muggy conditions, was visited by the trainer and doctor in the second set.

He was broken to trail 2-1, Alcaraz going on to take a 4-2 lead with a drop shot that Djokovic couldn’t touch.

But the 23-time Grand Slam winner drew cheers as he broke Alcaraz to climb back in, leveling the set at 4-4 on the way to a tie-breaker.

Alcaraz had a chance to put it away, but Djokovic saved a match point at 5-6 in the tie-breaker. They went to a third set when Alcaraz dumped a shot into the net on Djokovic’s second set point.

Djokovic headed off to the locker room for another clothing change while Alcaraz pounded his right hand on his bench in frustration as he sat down.

The Spaniard — who then needed to have a finger taped up — was broken in a nine-minute seventh game that featured five break points.

The back-and-forth battle continued, Djokovic unable to convert when he served for the match at 5-4 but putting it away two games later in what the ATP Tour said was the longest best-of-three set final in tour history.

A weary Djokovic dropped to the court in relief, then bounced up and ripped his shirt front down the middle as he let out a roar of triumph or agony — or perhaps a bit of both.

“I was never in doubt that I could deliver the match when it mattered the most,” he said, adding that the rivalry with Alcaraz “is just getting better and better.”

“Carlos is an amazing player, I have tons of respect for him,” Djokovic said.

“He is so poised at such a young age.”

Alcaraz did enough in Cincinnati to ensure he will remain number one in the world this week, and will be the top seed for his title defense at the US Open that starts on August 28.

Djokovic, who declined to be vaccinated against Covid-19, was playing his first US tournament in two years, a return Stateside that will now take him to Flushing Meadows, where he is a three-time champion.

With the win Djokovic, 36, became the oldest Cincinnati champion in the Open Era, surpassing Ken Rosewall who was 35 when he won in 1970.

COCO GAUFF POWERS TO THE BIGGEST TITLE OF HER CAREER

Earlier, Coco Gauff captured the biggest title of her career, powering past Karolina Muchova 6-3, 6-4 to win the WTA Cincinnati Open.

The 19-year-old American rushed to her box to hug her team members after securing her first 1000-level title over French Open runner-up Muchova in just under two hours.

Gauff was broken while serving for the straight-sets win, but two games later threw her hands up in joy after converting on her fourth match point.

“This is unbelievable,” said Gauff, who became the youngest winner of the Cincinnati WTA title and the first teenager to win five career titles since Caroline Wozniacki in 2008-09.

“Especially after Europe,” added the seventh seed, who was stung by a first-round exit at Wimbledon last month.

“I had a lot of nights crying and trying to figure it all out but this is great.” Gauff said she arrived on the US hard courts knowing what she needed to do to improve.

“I was going in practice and I was working on it. It just wasn’t translating into the matches,” she said.

“It still can get a lot better, the things I want to improve.”

She fired 16 winners with the same number of unforced errors in the final, breaking Muchova five times.

“Today I really won it off of breaking serve, to be honest,” said Gauff, adding that she didn’t serve as well as she did in her semi-final victory over world number one Iga Swiatek.

“I don’t know if it was nerves — I wasn’t that nervous, to be honest. Also a combination of the long match yesterday. I wasn’t serving as well.”

She had enough, however, to get past an equally weary Muchova, who ousted second-ranked Aryna Sabalenka in the semis.

“I think that’s what makes a champion, is how you’re doing on the days you aren’t feeling so great,” Gauff said.

“I think physically we were both feeling the impact of yesterday. I think for me, I was just able to persevere a little bit more in that final push.”

Since losing in the opening round at Wimbledon, Gauff has won 11 of her last 12 matches with her only defeat coming against Jessica Pegula last week in the Montreal quarter-finals.

Despite that hiccup she’ll go into the US Open starting in eight days on a high. She has now won five of her six career finals, including her first 500-level event at Washington two weeks ago and her first 1000-level title here.

Muchova will turn 27 on Monday with a career-best ranking of 10th.

“I’m really happy to make a top-10 debut,” she said.

“It’s always a thing that is in your mind when you play tennis, to make it to top 10. It’s happening for me tomorrow, so that’s really nice result.

“Today’s match, yeah, I fell a little short today,” she added.

“I was very hot. “Coco played great. She kept me in the rallies … it was tough to keep up with her.”

Gauff and Muchova twice exchanged breaks in the opening set, with the American coughing up three double-faults to lose the third game and dropping serve again in the seventh.

But a final break of the Czech off a backhand error handed the set to the crowd favourite after 44 minutes.

Gauff went up two breaks in the second set, giving back one before she closed out the victory.

“She’s very fast,” Muchova said of Gauff, who she played for the first time.

“I would say she really gets to most of the balls so you always have to expect that one more ball is coming.”