Harry Kane salvaged a point for Spurs in the final minute of stoppage time after tucking away the rebound when Adrian saved his late penalty.
West Ham thought they'd come away from White Hart Lane with three points in successive seasons thanks to goals from Cheikhou Kouyate and Diafra Sakho.
But Danny Rose gave Spurs hope with a speculative drive ten minutes from time, and Kane bagged Tottenham's equaliser deep into stoppage time after Alex Song brought the striker down clumsily in the box.
Mauricio Pochettino was questioned for resting Kane in Thursday's Europa League draw with Fiorentina, and there were more raised eyebrows at the Lane when Christian Eriksen began on the bench today.
But his side began proceedings the brighter team and almost took the lead when Kane ran through on goal under pressure only to poke his effort onto the outside of Adrian's post.
It appeared to spark the visitors into life with West Ham showing signs of threatening Hugo Lloris' goal in the minutes immediately after Kane's missed opportunity.
On 20 minutes, they made it count. An impressive passage of play between West Ham's midfielders resulted with the ball at Aaron Cresswell's feet, and the defender – one of eleven Englishmen to start the game – whipped in a teasing ball that Kouyate headed in from six yards.
So often, teams competing in the Europa League show signs of tiredness in their next Premier League match, and this Spurs side seemed visibly flat following their exerts against Fiorentina.
They were made to pay when West Ham doubled their lead just after the hour, as Sakho controlled a Mark Noble cross majestically and buried his volley past Lloris from a tight angle.
Kane thought he'd clawed Spurs back into it with 15 minutes remaining, but the England under-21 star was judged to be in an offside position after his initial header was saved by the West Ham goalkeeper, and he prodded home the rebound.
Five minutes later, Spurs found what they were looking for. Danny Rose drilled a speculative and scuffed effort at the West Ham goal which bounced awkwardly over Adrian and into the net.
Roberto Soldado was denied by a brilliant Adrian save late on as the home side began to resign themselves to defeat, but they were handed a gift by West Ham midfielder Song – so often reliable this season – when he brought down Kane naively in the box as the referee started thinking about blowing for full time.
Adrian could only block Kane's resulting spot kick back into the striker's path and he guided the ball past him to deny West Ham three points.