Archie Gray volleyed in from close range just after the hour to pull Spurs back onto level terms after Malick Thiaw's opener had given the Magpies the advantage at the Tottenham Hotspur Stadium.
But United responded swiftly, with Ramsay sweeping home his first goal in a Newcastle shirt following some good work from Anthony Gordon on the left.
The visitors dominated the first 45 and were good value for their half time lead, with Anthony Elanga instrumental in forcing a couple of early corners before crossing for Sven Botman to head over.
Xavi Simons dragged a shot through Kieran Trippier's legs and into the sidenetting for the hosts, but Willock went even closer for the Magpies, firing just wide of the target after some neat build-up play involving Harvey Barnes, Gordon and Bruno Guimarães.
Elanga could have felt a little aggrieved not to have an assist to show from his bright start, with Barnes backheeling a low cross from the Swedish international straight at Spurs stopper Guglielmo Vicario.
Ramsey, brought back into the side by head coach Howe following Saturday's defeat to Brentford, latched on to a Dan Burn knock-down just over quarter of an hour in, but didn't connect cleanly with the strike. Just before the half hour, he took aim again, whistling a powerful shot just past the upright.
Just before the break, United thought they had deservedly moved in front. Ramsey's through ball released Willock down the middle, and the former Arsenal man cut inside and buried a shot beyond Vicario. It was a superb finish but after a protracted VAR check, the goal was ruled out for offside, with Willock's forehead ever so fractionally beyond the last man when Ramsey played him in.
The disappointment didn't last long though, and Willock had a hand in Thiaw's opener. His cross for the German international was an excellent one, and while the centre back's header was saved by Vicario, Thiaw followed in to prod home the deadlock-breaker deep in stoppage time.
The Magpies started the second half well too, with Gordon and Willock constant threats and Elanga seeing a penalty appeal waved away after falling under the challenge of Djed Spence. Ramsey then saw two efforts blocked from successive Guimarães corners before Simons felled Willock as he shaped to shoot. Again, referee Anthony Taylor was unmoved.
Spurs' best move of the game brought their first real chance seven minutes after the restart. It owed much to the work of Archie Gray on the right, with the youngster skipping past a challenge and driving into the box before squaring for substitute Mathys Tel, whose finish was high and wayward. Pape Matar Sarr then forced Nick Pope into a smart save with a drive from distance as Thomas Frank's side rallied.
And they were rewarded for their improved showing in the second half when Sarr turned a corner back into the six-yard box and Gray hooked in a leveller from point-blank range.
It didn't deter United, though, and after Gordon's mazy dribble brought him back into the Spurs box his lay-off into the path of Ramsey was perfect - as was the former Aston Villa man's low finish with his unfavoured left foot which gave the Magpies the lead once more.
**Newcastle United:** Nick Pope; Kieran Trippier, Sven Botman, Anthony Gordon, Harvey Barnes, Malick Thiaw, Anthony Elanga (Sandro Tonali 75), Joe Willock, Dan Burn, Bruno Guimarães (c), Jacob Ramsey (Jacob Murphy 75)
**Substitutes:** Aaron Ramsdale, Lewis Hall, Yoane Wissa, Will Osula, Nick Woltemade, Alex Murphy, Leo Shahar