A tense duel in Sacramento ended with tempers flaring as the Bucks' Brook Lopez and Sacramento's Trey Lyles clashed angrily in the closing seconds, sparking a mass melee and the ejection of both players.
Antetokounmpo finished with 12 rebounds and four assists in addition to his 46 points as the Bucks found their scoring touch in the third and fourth quarters to pile up 80 second-half points.
Two-time NBA Most Valuable Player Antetokounmpo had missed the Bucks' last three games, including Saturday's defeat to the Golden State Warriors in San Francisco.
But his return to the line-up couldn't have been more timely against a Sacramento team who have emerged as the surprise package of the Western Conference, where they sit in third place behind Denver and Memphis.
Antetokounmpo was backed by 31 points from Khris Middleton and 23 points from Lopez as the Bucks overturned a 15-point deficit to claim victory.
De'Aaron Fox led Sacramento's scoring with 35 points from 13-of-23 shooting.
The win cemented Milwaukee's grip on top spot in the Eastern Conference.
The Bucks improved to 49-19 and have opened up a 2.5 game lead over second-placed Boston, surprisingly beaten by lowly Houston earlier on Monday.
In other games on Monday, Klay Thompson flirted with breaking his single-game three-point shooting record as Golden State claimed another heavyweight scalp with a 123-112 win over the Phoenix Suns at the Chase Center.
Thompson finished with 38 points, 33 of them scored in a remarkable first half that included eight three-pointers.
Thompson's touch deserted him in a scoreless third quarter, however, meaning he was unable to challenge his record of 14 threes in a game set in 2018.
"There's gonna be lulls -- I wish I could score 33 points every half but I'm much more satisfied with the win," Thompson said.
Steph Curry finished with 23 points and Jordan Poole 20 for the Warriors, who improved to 36-33 and are fifth in the Western Conference standings.
CELTICS STUNNED BY ROCKETS
The upset of the day came in Houston, where the Rockets stunned Boston 111-109 despite a 43-point performance from Celtics ace Jaylen Brown.
The second-placed Celtics had been looking to close the gap on Milwaukee against a Houston team who are propping up the Western Conference with the league's worst record.
But the Celtics were caught cold by a fired-up Houston, who shared the scoring around in a tight contest that saw 15 lead changes.
Jalen Green led the Rockets scoring with 28 points while five Houston players finished in double figures.
Boston could have forced overtime but Jayson Tatum missed a driving layup in the final seconds as Houston held on for the win.
"You've got to take the shots you have when you're open," Celtics coach Joe Mazzulla said. "Offensive rebounds, second chance points, turnovers -– that's the game."
In other games, Jimmy Butler guided Miami to victory down the stretch in the Heat's 119-115 win over the Utah Jazz.
"Jimmy's energy, relentlessness and aggressiveness in these kind of minutes is super-unique," Miami coach Erik Spoelstra said.
Butler finished with 24 points as seven Miami players finished in double figures.
Tyler Herro and Gabe Vincent finished with 18 points apiece while Bam Adebayo added 16 points and Kevin Love 11. Victor Oladipo and Caleb Martin combined for 21 off the bench.
Lauri Markkanen led Utah's scoring with 38 points but Miami showed the greater composure at key points in a game where the lead changed hands 17 times.
Miami, who improved to 37-33, are seventh in the East, one spot outside the automatic postseason playoff spots with 12 games left.
"We just have to continue to grind and figure out how to win some other skirmishes," Spoelstra said.
"At this point, with 12 games left, it's just however we need to do it, we just have to do it."
