Kyle Kuric added 13 points for seventh-seeded Louisville (26-9), which was in the championship for the third time. The Cardinals won the title in 2009 and lost to Connecticut in last year's championship game.
The game was far from offensive classic but it had the sellout crowd of 20,057 at Madison Square Garden on their feet in the final minutes.
''The problem with this game is, Cincinnati and Louisville know each other too well,'' Cardinals coach Rick Pitino said. ''The coaches know each other, they've worked together. So you can't run one play without the coaches on the other side yelling it out. So defense has to win it.''
Cashmere Wright had 16 points for the fourth-seeded Bearcats (24-10), who were in the title game for the first time.
This was in the first time in the 34 years the tournament has been held that at least one of the original seven members of the conference wasn't in the championship game.
Louisville looked to be in control when Smith — whose brother J.R. joined the Knicks during the season - hit a 3-pointer that gave the Cardinals a 44-28 lead with 8:27 to play. But Wright had nine points in a 16-4 run that brought the Bearcats within 48-44 with 2:35 to play.
Russ Smith's two free throws were the only points either team scored the rest of the way. Cincinnati had three possession trailing by four points but came up empty on each of them.
Tournament MVP Peyton Siva had 10 points, four rebounds and five assists for Louisville, which will be making its sixth consecutive appearance in the NCAA tournament. Siva averaged 15 points, seven rebounds, six assists and three steals in the first three games of the tournament.
''Nobody really expected us to even get this far,'' Siva said. ''It just feels good because a lot of people wrote us off. Coach P had a lot of faith in me. I'm very thankful for that. Everybody really showed a lot of heart today.''
He was humble about being selected MVP.
''My teammates are really the people who deserve this trophy,'' he said on the court as the nets were being cut down.
Even though the matchup was new for a Big East championship game, it was one between old adversaries. Louisville leads the all-time series 54-41 and this was the third different conference tournament they met in.
Louisville won all three meetings in the Metro Conference tournament, while Cincinnati won all three matchups in Conference USA. They are now 1-1 in the Big East tournament.
Cincinnati won the only regular-season meeting, 60-56. In that game the Bearcats went 11 for 27 from 3-point range in that game and Louisville made only one of its 14 attempts from beyond the arc.
This game was quite different.
Louisville finished 5 for 14 on 3s while the Bearcats were 3 of 14 and that included them missing their first nine.
The Cardinals led 24-14 at half and even though Cincinnati picked the scoring pace considerably, they were able to take the 16-point lead.
Wright, who had 22 points in the first meeting, took over when Cincinnati made the run. He hit a jumper, made a 3 and scored on two drives as what looked to be an easy win for Louisville became a close game.
Jaquon Parker was credited with a basket on an offensive goaltending call to get the Bearcats within 48-44 with 2:35 left.
Louisville came up empty on its next three possessions — a turnover and two missed shots — but the Bearcats couldn't take advantage as Wright turned the ball over, Parker missed a jumper and then two free throws.
Pitino improved to 26-9 against his former assistants and is now 5-4 over Cincinnati's Mick Cronin, who worked for him at Louisville from 2001-03. Cronin was the second former assistant Pitino beat in this tournament as the Cardinals beat Seton Hall and coach Kevin Willard in the second round.
Louisville led 24-14 at halftime with the Bearcats just four points better than the Big East tournament record for fewest points in a half. The way they were shooting it would seem the record was a lock.
Cincinnati missed 11 of its first 12 shots from the field and the drought kept up even longer from 3-point range as the Bearcats missed all nine attempts from beyond the arc. In the semifinal win over Syracuse they made six of their first seven 3-point attempts.
Louisville wasn't exactly lighting up the scoreboard but the Cardinals were 9 of 24 (37.9 percent) and they made 3 of 10 from 3-point range.