Ricky Alvarez put Inter head on 29 minutes before Arturo Vidal equalised from the spot just before the break, and with nothing to separate the sides for the remainder of normal time, penalties went on to decide the match.
Half-time substitute Juan Pablo Carrizo was the hero for Inter, the goalkeeper first saving Mauricio Isla's effort in the 10th round of kicks before stepping up himself to net the decisive penalty.
It was a battle to avoid the wooden spoon, as both teams had previously suffered back-to-back defeats: the Nerazzurri fell 2-0 to Chelsea and 4-0 to Valencia, while the Bianconeri lost on penalties to Everton and 3-1 to LA Galaxy.
Both teams made numerous changes to field an almost full-strength starting XI. Hugo Campagnaro returned from suspension for Inter, but Walter Samuel, Mateo Kovacic, Diego Milito and Javier Zanetti were sidelined.
Mirko Vucinic nodded an Andrea Pirlo free-kick over from eight yards, while Gigi Buffon pulled off a stunning save to deny Rodrigo Palacio, who had wandered marginally offside anyway.
Pirlo curled a free-kick just wide, but Inter broke the deadlock when Buffon only parried a fierce Fredy Guarin effort into the path of Alvarez. It was the first goal the Nerazzurri had scored in this tournament.
Alvarez created a fantastic chance for his brace when sprinting down the right and cutting back past Leonardo Bonucci, but fired wide of the near post.
The referee pointed to the spot before half-time, as Juan Jesus rather clumsily brought down Vucinic. Vidal stepped up and converted powerfully despite Samir Handanovic guessing the right angle.
The Chilean volleyed over from a corner and Carlos Tevez set up a chance that Claudio Marchisio turned into the side-netting.
Alvarez failed to get on the end of a Palacio counter-attack and Marco Storari smothered a Yuto Nagatomo snapshot.
Pirlo thought he had won it for Juve on 77 minutes when his free-kick curled over the wall, but it thumped the base of the upright with Juan Pablo Carrizo rooted to the spot.
The Turin giants threatened again with a corner, as Carrizo dived out to capture the ball before anyone could get the final touch from six yards.
As neither side could snatch a winner, the tie had to be decided on penalties. Sebastian Giovinco went up first and saw his spot-kick saved by Carrizo. However, Guarin had the exact same result against Storari.
The penalties continued, including a cheeky Mauro Icardi chip, until it went to sudden death and beyond. Eventually at the 10th round of spot-kicks Carrizo saved from Isla and then the goalkeeper went to take the winner himself, beating Storari.
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