The Cardinals (7-0) came back from two big deficits — nine in the second half and five in overtime. Kyle Kuric's 16-footer gave Louisville a 60-58 lead with 34 seconds left.
John Jenkins, who finished with 27 points, hit two free throws for the Commodores (5-3) to tie it with 12.2 seconds to play, but Siva broke the defense on a high pick-and-roll and got to the hoop for the game-winning basket to finish with 15 points.
Siva, who has been hobbled recently by a sprained left ankle, smiled watching his big layup on replay following Louisville's 15th straight win in the KFC Yum! Center.
Siva and Louisville freshman Chane Behanan finished with 14 points apiece, but Behanan blew a chance to win it in regulation when he missed a short shot at the buzzer. He'd make amends in overtime.
Jenkins gave Vanderbilt a 55-50 lead when he opened overtime with a 3-pointer, then added two free throws with 2:29 left. Behanan answered with a three-point play. After the two teams traded a pair of free throws, Kuric, who finished with 15 points, hit a 3-pointer that gave Louisville a 58-57 lead.
Brad Tinsley tied it with a free throw before Kuric's jumper set up the final sequence when Jenkins hit two free throws and Siva easily passed Lance Goulbourne down the lane, hitting a finger-roll layup with 1.4 seconds left.
Behanan deflected Tinsley's full-court desperation pass. Goulbourne and Jeffrey Taylor finished with 11 points apiece.
It was the first true road game for a Vanderbilt team that had been ranked seventh in the preseason poll — ahead of Louisville at the time — and while the Cardinals have weathered injuries, the Commodores have struggled.
Vanderbilt is still without Festus Ezeli (right knee) for two more weeks and also lost Josh Henderson (left foot). Henderson is scheduled to have surgery Monday to put a screw in his foot and will miss eight to 12 weeks.
Louisville is missing Rakeem Buckles (right knee), Stephan Van Treese (left knee), Mike Marra (left knee), Wayne Blackshear (right shoulder) and Elisha Justice (broken nose).
Just like in an overtime loss to then-No. 11 Xavier when the Commodores gave away a 10-point lead at home, Vanderbilt squandered a big second-half advantage.
Jenkins' jumper gave the Commodores a 43-34 lead, but Taylor made a steal and missed a layup that would've pushed it to double digits.
Louisville answered with a 13-4 run that ended with Behanan's steal and slam that tied it with 2:28 left.
The two teams then swapped inconsistent performances at the free-throw line. Goulbourne hit one to put Vanderbilt up by a point, Siva made two to give Louisville its first lead in 18 minutes and Brad Tinsley hit one of two that tied the game at 49 with 1:26 left.
Gorgui Dieng and Steve Tchiengang each hit one free throw. But Dieng misplay a rebound of Tchiengang's second attempt to give the Commodores a chance with 39 seconds left.
Tinsley threw the ball into the Commodores' bench for a turnover, giving the Cardinals a final chance.
Siva wound the clock down near halfcourt, then drove into the lane around Taylor and found Behanan down low. Behanan took the ball to the floor once to slice across the lane, but missed the shot off the backboard and rim and slumped down in frustration at failing to hit the winner.
Siva made sure the next time he'd take it all the way.
Louisville 62, Vanderbilt 60 OT
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