Miami's Manu Lecomte missed a chance to put the Hurricanes in front in the closing seconds of regulation and the Panthers made them pay with their sixth win in their last seven road games.
Rion Brown put Miami ahead with a 3-pointer to start overtime, but the Hurricanes did not score for the next two minutes.
Pittsburgh went in front for good with 2:27 to go on a layup by Patterson, but Miami was still within one thanks to a jumper by Brown with 17 seconds to play.
Patterson then made good on 3-of-4 attempts to the foul line to put the game away. He finished with 25 points, helping Pittsburgh climb to 19-4 for the season and to 7-3 in the Atlantic Coast Conference.
Brown led Miami (11-11, 2-7 ACC) with 21 points. It was the Hurricanes' fourth loss in five games.