Much was owed to winger Chris Burke, this week recognised by second-tier managers as one of the top 10 players in the division, who claimed two assists to take his tally to 13 this term - the highest of any Championship player.
The Scot's 11th-minute cross set up Nikola Zigic, whose low header produced his ninth goal of the season and set the hosts on their way to a first win in six games in all competitions since losing their 15-match unbeaten record.
Boro, despite just one win at St Andrew's in 33 years, remained in the game and posed a threat having claimed more points on their travels than at the Riverside this season - Joe Bennett seeing a neat finish ruled out by an assistant's late flag.
That threat was extinguished however thanks to two goals in three minutes around the hour mark, Burke setting up Marlon King for a well-taken strike before man of the match Keith Fahey capped a marauding run with a composed finish.
It was the visitors who started on the front foot, Lukas Jutkiewicz forcing a solid parried save from Boaz Myhill.
But the pattern of play changed completely with City's 11th-minute opener.
Burke delivered an inch-perfect cross from the right and Zigic got down well to divert home a low header at the near post.
Burke looked to get his name on the scoresheet minutes later with a 30-yard strike which was well saved by Jason Steele.
Adam Hammill fired narrowly wide for Boro before Jutkiewicz, all alone in the Blues box, fluffed a great opening to level matters.
A brief lull in proceedings was almost brought to life by Burke's header, which looped narrowly over the crossbar.
Matthew Bates then produced a perfectly-executed sliding challenge to deny King, who had been sent clear by the galloping Andros Townsend, ensuring the encounter remained well poised at the break.
Justin Hoyte diverted Zigic's effort behind for a corner at the start of the second half.
Bennett thought he had equalised with a well-taken finish from Hammill's through-ball shortly after, only to be denied by a late flag from the assistant referee.
And no sooner had the goal been ruled out than the game was taken beyond Boro's reach.
Burke squared the ball to King, who finished from 12 yards, before a swift counter-attack was led from his own half by Fahey and the Irishman completed his run with a cool finish under Steele.
Tony Mowbray made a triple substitution in an attempt to revive his side's fortunes.
But Middlesbrough were denied what would merely have been a late consolation by a contender for save of the season from Myhill, who somehow got down to deny Seb Hines.