The Millers are 22nd in the table and six points behind 21st-placed Birmingham City, but they have four games in hand over the Blues, while the Robins sit with little to play for in 13th.
Rotherham lost 4-1 to Watford on Tuesday in their first game in two weeks after recording several positive cases of coronavirus.
The defeat was their joint-heaviest of the season and the first time they have conceded four in game, with most of their losses this season coming just by the single goal.
Boss Paul Warne has been self-isolating and will be absent again for the trip to Ashton Gate, and assistant manager Richie Barker admitted that "everything just felt a bit alien" in midweek as some players were not fully fit due to a lack of game time or training.
It is far from an ideal backdrop for the Millers as they battle to stay in the division, and they would surely much prefer to have points on the board rather than games in hand.
The strugglers have lost six of their last seven games but have actually been promising away from home, winning four of their last six matches on the road.
Rotherham won this season's reverse fixture 2-0 at the New York Stadium in December, their first victory in six matches against Bristol City, but they have not won at Ashton Gate since 2013.
However, the Robins have lost their last five home matches, only scoring once in that time; Pearson has been unable to change the tide in that regard since taking over a month ago, but he has certainly steadied the ship on the River Avon.
A 0-0 stalemate against Blackburn Rovers on Wednesday, which Pearson described as a "dogged performance", was a second successive clean sheet – the first time they have achieved that since November.
Incredibly, it was Bristol City's first draw in four months too and only their fourth game this season to end level. No side in the Championship has picked up fewer draws, although Rotherham have only had five, suggesting that it is unlikely that this game will finish all square.
It is now three wins, one draw and two defeats for Pearson, giving him a tally of 10 points, which only four sides have beaten since he took charge.
Bristol City goalkeeper Dan Bentley missed Wednesday's draw with Blackburn through illness but is in contention to return on Saturday.
Nathan Baker is edging ever closer to a first appearance of the season after suffering a hamstring injury six months ago but may be saved until after the international break, particularly with the Robins keeping two successive clean sheets with the same back four.
Warne has suggested that the two-week international break that follows this game will mean that his players will be "leaving everything down there", and he will not look to rest any key individuals.
Ben Wiles picked up a hamstring strain in the defeat to Watford, but Warne is hopeful that the midfielder will be fit for the trip to Ashton Gate.
Bristol City possible starting lineup:
Bentley; Hunt, Kalas, Mariappa, Sessegnon; Massengo, Lansbury; Semenyo, Palmer, O'Dowda; Diedhiou
Rotherham United possible starting lineup:
Johansson; Wood, A. MacDonald, Ihiekwe; Olosunde, Barlaser, S. MacDonald, Wiles, Harding; Crooks, Ladapo
We say: Bristol City 0-1 Rotherham United
Rotherham are desperate for the points and a siege mentality seems to be forming in the Millers camp, which may drive them on to all three points here. Pearson has made Bristol City a more resolute side, but they do not have the same motivation as the visitors.