Romelu Lukaku returns with Andrea Belotti for Roma, while Napoli cling to Victor Osimhen and Kvicha Kvaratskhelia following their Coppa Italia shocker.
It kicks off at the Stadio Olimpico at 19.45 GMT.
This is a head-to-head for the chance to remain in the running for a top four finish, but both sides are struggling at the moment.
Roma hit problems in a 1-1 draw with Fiorentina when down to nine men, then lost to Bologna to slide down the standings.
Lukaku and Nicola Zalewski have completed their bans, but Paulo Dybala, Houssem Aouar, Chris Smalling, Marash Kumbulla and Tammy Abraham are still injured.
Renato Sanches is not even on the bench, as he is suffering from flu symptoms.
Napoli keep taking one step forward and two back under new coach Walter Mazzarri, because following three consecutive defeats in all competition, they had got back on track beating Cagliari 2-1.
It all went very wrong on Wednesday in the Coppa Italia Round of 16, suffering a humiliating 4-0 home defeat to Frosinone.
Jesper Lindstrom, Mathias Olivera and Eljif Elmas (who is practically sold to RB Leipzig for €25m) are unavailable.
It was when Osimhen and Kvaratskhelia came off the bench that Napoli crumbled against Frosinone, so the pressure is on them to make up for it.
Roma: Rui Patricio; Mancini, Llorente, Ndicka; Kristensen, Cristante, Paredes, Bove, Zalewski; Belotti, Lukaku
Napoli: Meret; Di Lorenzo, Rrahmani, Juan Jesus, Mario Rui; Anguissa, Lobotka, Zielinski; Politano, Osimhen, Kvaratskhelia
Player statistic
Leandro Paredes | 28' | |||
28' | Mário Rui | |||
Rasmus Kristensen | 32' | |||
Bryan Cristante | 38' |
Andrea Belotti | 60' | |||
62' | Juan Jesus | |||
Nicola Zalewski | 65' | |||
66' | Matteo Politano | |||
73' | Victor Osimhen | |||
Lorenzo Pellegrini (Assist: Stephan El Shaarawy) |
76' | |||
Stephan El Shaarawy | 82' | |||
86' | Victor Osimhen | |||
Sardar Azmoun | 90+5' | |||
Romelu Lukaku (Assist: Evan Ndicka) |
90+6' |