After trailing by as many as 16, Austin Rivers hit a 3-pointer for the Hornets to tie it at 92 with 50.9 seconds left. The Blazers then absorbed a blow when LaMarcus Aldridge suddenly came up limping and headed to the locker room with what appeared to be a left ankle injury, but Lillard came through to give Portland the win.
The winning shot appeared to come at the buzzer but a review put the fraction back on the clock. Lance Thomas made a layup for the Hornets as time ran out for the final margin.
J.J. Hickson had a season-high 24 points and added 16 rebounds for the Blazers, who have won three straight. Hickson has five straight double-doubles and 13 overall this season.
Ryan Anderson had 26 points, including seven 3-pointers, for New Orleans.
Aldridge, whose condition was not immediately available, finished with 20 points before leaving the game and Lillard had 16.
Wesley Matthews, who hit a 3-pointer to open the night for the Blazers, was making his return to the starting lineup after missing two games because of a strained left hip. The injury put him on the bench in street clothes for the first time in his four-year NBA career. He had played in 250 straight games, second-most among active players behind Oklahoma City's Russell Westbrook.
Matthews was replaced by Victor Claver less than five minutes into the game and did not return. The Blazers said there was no specific injury, he just "didn't feel right."
Lillard stole the show in the battle of the rookies with Anthony Davis.
Davis, the top pick in last June's draft, if still getting his legs back after missing 11 games with a left ankle injury. In the first three games off the bench since his return, he averaged 11.7 points and 6.3 rebounds for the Hornets.
Against the Blazers he had 15 points. Before the stress reaction in his ankle, Davis was averaging 16 points and 8.3 rebounds.
Lillard, the sixth overall pick in the draft, has been the Western Conference's rookie of the month for both October and November, and was leading all rookies with an average of 18.9 points going into Sunday night's game.
Portland went up 36-26 midway through the second quarter on Sasha Pavolic's reverse layup. Hickson pushed the lead to 51-38 with a layup and the Blazers went into the break ahead 54-43
Aldridge's dunk made it 67-53 midway through the third quarter. But it was Hickson's 11 points that helped put the Blazers up by as many as 16 in the period.
Anderson's putback layup closed the Hornets to 82-75 with 7:55 left, but Luke Babbit answered for the Blazers with a 3-pointer.
Anderson made a pair of free throws to close New Orleans to within 85-80. His 3-pointer pulled the Hornets to within 90-87 with 3:21 left. Lance Thomas got them closer with a putback but Aldridge had a step-back jumper with 1:04 to make it 92-89.
Earlier Sunday, the Hornets signed forward Dominic McGuire to shore up their frontcourt in the absence of Jason Smith, who is out with a right shoulder injury. Smith was injured in the Hornets' loss at Oklahoma City earlier this week and is expected to be out about two weeks, coach Monty Williams said.
McGuire averaged 2.1 points and 3.2 rebounds in just over 15 minutes per game for the Toronto Raptors earlier this season, appearing in 15 games before he was waived on Nov. 30.
"He's got a toughness about him that I think can help us out," Williams said.
Notes: The Blazers held a moment of silence before the game for the victims of the Sandy Hook Elementary School shooting before the game. It is the second straight game with a moment of silence: On Thursday the team remembered the victims of the Clackamas Town Center mall shooting in suburban Portland.