CINCINNATI, Ohio — 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 on Sunday.

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 (7), 7-6(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 Serbian star, who avenged his loss to the Spaniard in a five-set Wimbledon final last month.

The two — who have traded the No 1 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 for a 4-2 lead.

A few minutes later, however, the Spaniard returned the favor.

Alcaraz 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, tying the set at 4-4 on the way to a tiebreaker.

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

'Tons of respect'

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 the circuit's 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 No 1 in the world this week, and will be the top seed for his title defense at the US Open that starts on Aug 28.

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

AFP