The Irishmen needed two bites of the cherry to apply the finishing touch after Rams keeper Stephen Bywater had pulled off an excellent double save.
But the Black Cats striker hooked the ball over his shoulder and into the net to break Derby hearts in time added on at the end of the 90 minutes.
It was more than the home side deserved but that won't worry boss Roy Keane who looked a mightily relieved man as the ball nestled in the back of the Derby goal.
Keane dropped record signing Craig Gordon, striker Michael Chopra and defender Ian Harte as he rang the changes following last weekend's 7-1 drubbing at Everton.
The Sunderland boss no doubt hoped that by bringing Darren Ward, Greg Halford and Andrew Cole into his side it would revitalise the team.
However, it failed to have the desired effect as the Wearsiders laboured in front of goal and wasted possession in the middle of the park on far too many occasions.
Ward did make one great save in the first half to deny Kenny Miller, tipping the Scot's goalbound effort onto the post.
It was the Rams who looked the brighter of the two sides in the opening half although to be fair there wasn't much in it.
Neither team really produced anything in the way of entertaining football with Miller's shot and a Kenwyne Jones strike which came back off the post the closest either side came to opening their account in the first half.
In fact the game looked to be heading for a no-score bore draw before Stokes applied the finishing touch for Sunderland's goal.
The result was harsh on County who find themselves rooted to the bottom of the table and in particular on Bywater who denied both Stokes and Jones in the build-up to the winner.
Liam Miller's cross into the area was met by the head of Jones, but Bywater produced an excellent one-handed stop only for the ball to find Stokes.
The former West Ham United keeper then somehow managed to get a hand to the Irish striker's header but, when the ball came back to Stokes, the Rams keeper could only look on in despair as the Sunderland forward hooked the ball over his shoulder and into the net.
It was relief all round for the home supporters among the 42,380 crowd while the Derby fans must have felt like they had been mugged.
A draw would have been a fair result as neither team deserved anything from a dreadful afternoon's football. On this showing it looks like it could be a long, hard and fruitless season for both Rams and Black Cats alike.