Rotherham have won one of their last nine games and are in the relegation zone, while Cardiff's playoff hopes have taken a serious dent following three defeats in a row.
Rotherham appeared to have revived their season with a 2-0 win over Bristol City two weeks ago, but they have since lost 2-1 to Blackburn Rovers and Barnsley.
That most recent loss at the hands of their South Yorkshire rivals leaves the Millers 23rd, only kept off the bottom of the table by Wycombe Wanderers.
Wycombe are now within a point of Rotherham, though, after picking up a victory over United's next opponents Cardiff earlier this week.
The Bluebirds fell to a 2-1 reverse at Adams Park in what will surely be the nadir of their campaign.
It marked the ninth defeat of their season and a third on the spin, with the pressure now seriously growing on boss Neil Harris, who was sent to the stands.
To make matters worse for City, they have lost their first league match in each of the last three calendar years, including a 6-1 loss at the hands of Queens Park Rangers in 2019.
Another defeat this weekend, regardless of the manner of the scoreline, could well bring an end to Harris's tenure.
Cardiff's disappointing run includes back-to-back defeats on their travels to Norwich City and Wycombe, though they have won two of their last three games away to Rotherham.
Indeed, the Yorkshire outfit have won just one of the last 10 league meetings with Cardiff, losing 5-0 in the most recent match in February 2017.
Rotherham United Championship form: LLLWLL
Cardiff City Championship form: WLWLLL
Barnsley are one of a number of Championship clubs to be heavily hit by coronavirus cases in recent days, with numerous players being forced to isolate.
Cardiff do not have such issues to worry about, but they will be without manager Harris after he was sent to the stands last time out.
Rotherham United possible starting lineup:
Johansson; Wood, Ihiekwe, Harding; Olosunde, Wiles, Barlaser, Lindsay, Jozefzoon; Ladapo, Smith
Cardiff City possible starting lineup:
Smithies; Bacuna, Benkovic, Nelson, Bennett; Ralls, Vaulks; Ojo, Wilson, Hoilett; Glatzel
We say: Rotherham United 0-2 Cardiff City
This is surely a do-or-die match for Cardiff boss Harris on the back of three straight defeats.
Rotherham are themselves in need of points, but we can see the Bluebirds getting their campaign back on track with victory at the New York Stadium.