Egor Chinakhov and Ben Kindel scored in the shootout for Pittsburgh.
Erik Karlsson had a goal and two assists for the Penguins (36-20-16), who had lost two in a row and are 2-2-1 in their past five games. Stuart Skinner made 26 saves.
Pittsburgh moved into second place in the Metropolitan Division, one point ahead of the Columbus Blue Jackets.
Sidney Crosby left early in the second period for the Penguins and did not return.
He had previously gone down the tunnel following his last shift of the first period after appearing to get his left leg tangled up. Crosby had one shot on goal in 6:39 of ice time.
The 38-year-old center missed 11 games with a lower-body injury sustained during the second period of Team Canada’s 4-3 overtime win against Team Czechia in the quarterfinals at the 2026 Winter Olympics on Feb. 18. He did not play in the semifinals and a 2-1 overtime loss to Team USA in the gold medal game on Feb 22.
Drake Batherson scored twice, and Tim Stutzle had two assists for the Senators (38-24-10), who had won four straight and are 15-3-3 in 21 games since Jan 25. Linus Ullmark made 35 saves.
Batherson scored on the power play to give Ottawa a 1-0 lead at 4:28 of the first period, finishing a cross-crease pass from Brady Tkachuk.Â
With the secondary assist, Stutzle became the youngest player in Senators history to reach 400 points.
Rakell tied it 1-1 at 13:46. After a clearing attempt by Tyler Kleven was kept in at the blue line by Karlsson, he found Rakell in the high slot, where he beat Ullmark with a snap shot left corner.
Cousins regained the lead for Ottawa, 2-1, at 1:50 of the second period. Off the rush, Cousins attempted to pass across to Michael Amadio, but the puck deflected off defenseman Samuel Girard and back to Cousins, who tapped it in on the backhand.
Karlsson tied it 2-2 at 3:45, connecting again with Rakell for a goal from the left face-off circle.Â
Rakell gave the Penguins a 3-2 lead at 1:43 of the third period, their first of the night. On a 5-on-3 power play, Karlsson fed Rakell at the left dot for his seventh goal in his past six games.
Batherson’s second goal of the game tied it 3-3 at 3:58 after collecting a netfront rebound from a Stutzle shot following the face-off. The Penguins challenged for goaltender interference, but the call on the ice stood following video review.
Both sides made multiple big saves in overtime, including Ullmark robbing Thomas Novak on the breakaway with under 20 seconds to go.