Tottenham Hotspur 2-1 Birmingham City
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Two Roman Pavlyuchenko goals secured fifth place for Spurs, but a 2-1 loss at White Hart Lane saw Birmingham City relegated.
Blues boss Alex McLeish opted to field a five-man midfield, with Cameron Jerome acting as the lone striker, while Spurs partnered Peter Crouch and Jermain Defoe in attack.
The opening minutes saw few openings at either end, but nine minutes in Ben Foster had to make a decent save to push away a Crouch effort.
With City struggling to make any headway against the home defence, it was left to Foster to keep his side level with just over 25 minutes played.
The former England man tipped away a Defoe header from six yards, thwarting his ex-international colleague, who has scored just a handful of Premier League goals this season.
Crouch had to go off with an injury shortly before half-time and Foster was right behind a long-range Luka Modric effort as the first half drew to a goalless close.
Four minutes into the second half the home side broke the deadlock as Pavlyuchenko picked up a loose ball 25 yards out and curled a superb right-foot shot past Foster.
Scores at this point were still in City's favour, with Blackpool being beaten at Old Trafford to join West Ham in the Championship.
Craig Gardner crashed home what seemed to be a crucial equaliser 11 minutes from time, but news from Molineux proved to be devastating for Birmingham as Wolves fought back from 3-0 down to lose 3-2 to Blackburn Rovers.
That was enough to push the Blues into the drop zone on goals scored and Pavlyuchenko sealed their fate with a deflected effort deep into stoppage time.