49ers vs. Rams Prediction, Pick: Can Matthew Stafford continue winning in Week 18?

San Francisco and Los Angeles face off in an important division battle. Here's our 49ers vs. Rams pick and prediction for Week 18.

The San Francisco 49ers and Los Angeles Rams will face off in one of the most important games of the week. If San Francisco wins, they’re in the playoffs. If they lose and the New Orleans Saints win, they’re out. Los Angeles, on the other hand, is playing for postseason seeding. If they win, they’re the No. 2 seed. If they lose, they could drop to the fifth seed and a Wild Card slot instead of the division title. Here are the NFL odds, along with our pick and prediction for the 49ers vs. Rams game.

San Francisco 49ers vs. Los Angeles Rams pick, prediction | Week 18

  • Spread: Rams -4.5 (Odds provided by DraftKings Sportsbook)
  • Moneyline: 49ers +175, Rams -210
  • Over/Under: 44

San Francisco quarterback situation

Jimmy Garoppolo suffered a UCL tear and fractured thumb on his throwing hand in Week 16 against the Tennessee Titans. He wasn’t able to practice last week, ultimately missing San Francisco’s Week 17 matchup against the Houston Texans.

Trey Lance drew the second start of his career, flashing at times in a 23-7 win. He threw for 249 yards with 2 touchdowns and 1 interception on 23 pass attempts. He also added 31 yards on the ground.


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It’s unknown at this point whether Garoppolo will be able to play or not. With that said, there were several people that suggested it was going to be a multi-week injury.

Although Lance has the better career upside, Garoppolo could give the 49ers a better chance to win now. They each bring unique talents to the game, and San Francisco will be a live team regardless of who starts.

49ers vs. Rams betting trends

These squads are extremely similar in terms of the spread. They both own 8-8 against the spread (ATS) this season.

San Francisco has failed to cover by an average of 0.2 points per game, while Los Angeles has failed to cover by 0.5 points per game.

After starting out slow, the 49ers have covered the spread in six of their last eight games. The Rams had a bad stretch in the middle of the season, but they’ve covered the spread in four of their last five contests.

These teams are on opposite sides of the game total. Los Angeles enters this matchup with an 8-7-1 over/under record, while San Francisco’s sits at 7-9. They’re both close to neutral, though.

49ers vs. Rams prediction

Both of these teams have a lot to lose in Week 18. The major difference is that one roster is more talented. The Rams are sitting at the top of the NFC West for a reason, and I don’t expect the 49ers to knock them off of their recent streak.

Los Angeles will also have home-field advantage in this game. The one key for San Francisco at the moment is that the Rams don’t know who they should be preparing for, as Lance and Garoppolo are two completely different quarterbacks.

Regardless of the starter, I expect this game to stay close, and I’ll take the points with the underdogs. That said, I do expect the Rams to come out on top.

49ers vs. Rams Prediction: Rams 24, 49ers 20

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