In a game they were in control for the large part, Ghana's Black Stars conceded twice in stoppage-time to throw away a two-goal lead in 3 minutes to draw with Mozambique.
The Black Stars looked to be cruising into the last 16 thanks to two Jordan Ayew penalties, one in each half.
But Geny Catamo pulled one back from the spot on 91 minutes before Reinildo Mandava's header broke Ghana hearts.
Mozambique finish bottom of Group B, while Ghana need a miracle to progress as one of four best third-placed sides.
Richard Ofori maintained his position between the sticks, with the back four of Denis Odoi, Gideon Mensah, Mohammed Salisu and Alexander Djiku also unchanged.
In midfield, Abdul Salis Samed took his place as the anchor, while Majeed Ashimeru recovered in time to also start alongside the Lens man.
Jordan Ayew also made his third successive start in the 2023 AFCON after being deployed at left wing, with Paintsil also making a return to the starting line-up on the opposite flank.
West Ham United star Mohammed Kudus was once again tasked with being Ghana’s creative force and played behind striker Antoine Semenyo.
The Black Stars went into their final group game against the Mambas desperately in need of a win to enhance their chances of qualification.
Having failed to win any of their first two group matches after losing to Cape Verde and drawing with Egypt, Ghana made a quick start to the game and nearly opened the scoring after just 45 seconds via Semenyo’s shot, but his effort was tipped over by the Mozambican goalkeeper.
Hughton's side continued to push and their efforts paid off in the 15th minute when Paintsil was brought down in the box for a penalty. Jordan Ayew stepped up and converted to give Ghana the lead.
Ghana’s dominance waned from here on and Mozambique warmed themselves back into the game before the half-time break.
Despite the turnaround, it was the Black Stars who doubled their lead in the second half, with Ayew again scoring from a penalty after Kudus’ shot was blocked with an arm in the box.
The Black Stars seemed to be cruising and angling towards an important victory but were penalized in the 91st minute when Andre Ayew handled the ball in the box.
From the resulting penalty, Catamo halved the deficit before Mandava broke Ghanaian hearts in the fourth minute of added time with a fine header after Richard Ofori's blunder gifted the Mambas a corner kick.
Ghana are now on the brink of elimination, having garnered just two points from three matches, as they await the results of other groups to see if they will be part of the best four third-place teams.