Steelers quarterback Ben Roethlisberger left the game late in the first half after suffering a concussion. Roethlisberger was taken to a hospital for observation.
Willie Parker ran for 116 yards and a touchdown for the Steelers (12-4), the AFC North champion.
Byron Leftwich replaced Roethlisberger and ran for a touchdown.
The Steelers' Hines Ward caught six passes for 70 yards, surpassing 1,000 yards for the fifth straight year.
Cleveland (4-12) has gone 24 consecutive quarters without an offensive touchdown, an NFL record.
Jamal Lewis ran for 94 yards and quarterback Bruce Gradkowski completed only five passes for 18 yards for the Browns.