Vladimir Guerrero Jr. hit his 34th home run for the Blue Jays, who lost for the first time in four games since returning north of the border to Rogers Centre.
Recently acquired Toronto reliever Brad Hand (5-6) endured a rocky 10th, opening the inning with a wild pitch that allowed automatic runner Myles Straw to advance to third. Amed Rosario lined Hand's next pitch through the drawn-in infield for an RBI single.
Four pitches later, Ramirez homered off the left field foul screen, his 23rd.
''I was looking for a high pitch and thankfully that happened,'' Ramirez said through a translator. ''He threw that high pitch and I was able to put the ball in play.''
It was the 150th homer of Ramirez's career, 11 of which have come in the ninth inning or later.
Bryan Shaw (4-5) worked one inning for the win and Emmanuel Clase finished for his 14th save in 18 opportunities.
Cleveland is 6-5 in extra innings while Toronto is 2-6.
Harold Ramirez and Oscar Mercado had back-to-back RBI singles off Blue Jays left-hander Robbie Ray in third. Toronto tied it on Guerrero's two-run homer off rookie right-hander Eli Morgan in the sixth.
Recalled from Triple-A Columbus before the game, Morgan allowed two runs and five hits in career-high six innings. He walked one and matched a career-high by striking out nine.
Jose Ramirez said Morgan did a ''tremendous job,'' and acting manager DeMarlo Hale called Morgan's performance ''outstanding.''
''I thought he was one step ahead of them the first two times around the order because he threw his fastball a lot more,'' Hale said.
Ray gave up two runs and six hits in six innings.
''They definitely made me work today,'' Ray said.
CATCH OF THE DAY
Straw made a sliding catch on George Springer's drive to right-center to begin the ninth.
''I thought I had a good chance off the bat and sure enough I was able to get to it,'' Straw said.
DROPPING THE AX
The Blue Jays traded minor league RHP John Axford to Milwaukee for $1. The Canadian-born Axford, 38, began this season as a studio analyst on the Blue Jays' television broadcast crew. He signed a minor league deal with Toronto in June and posted an 0.77 ERA in 10 minor league appearances. Axford last pitched in the majors in 2018.
Springer was chosen as the AL player of the week after batting .400 with three home runs and seven RBIs.
Blue Jays: OF Corey Dickerson (left foot) took batting practice before the game and could be activated off the injured list this week, manager Charlie Montoyo said.
The Indians activated 1B Bobby Bradley off the bereavement list and optioned OF Daniel Johnson and INF Yu Chang to Triple-A. Both Johnson and Chang will remain on the taxi squad.
Blue Jays LHP Hyun Jin Ryu (10-5, 3.26) will try to win his fourth straight decision when he faces Cleveland RHP Zach Plesac (6-3, 4.26) on Tuesday night. It will be Ryu's first Toronto start since signing a four-year, $80-million deal with the Blue Jays in December 2019.
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