Having trailed to Paddy McNair's 33rd minute opener, the Lilywhites flipped the game on its head with two late goals.
Substitute Ched Evans headed PNE level in the 77th minute, then Emil Riis swept home the winner five minutes later.
North End were indebted to goalkeeper Daniel Iversen though, the goalkeeper making a string of saves with the scoreline at 1-0.
Here are the ratings for the North End players, with Iversen getting star billing.
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1. Daniel Iversen 9
The Danish goalkeeper kept PNE in the game at 1-0, making a string of saves. Pick of the bunch was touching a deflected shot on to the bar. Photo: Camerasport
2. Sepp van den Berg 6
Part of a defence which came under intense pressure early in the second half and had keeper Iversen to be thankful for. Put in some good challenges. Photo: Dave Howarth/Camerasport
3. Patrick Bauer 6
Had to really dig in for the first hour of the game with Middlesbrough on top. Handled strikers Watmore and Sporar quite well. Photo: Dave Howarth/Camerasport
4. Andrew Hughes 6
Lost track of McNair for the Middlesbrough goal but otherwise did okay. Brought the ball out from the back a few times as he attempted to get PNE playing. Photo: Dave Howarth/Camerasport