The 25-year-old has now picked up 13 wickets in his last two Sunfoil Series games after finishing with match figures of 7 for 95.
The Cobras remain bottom of the table despite picking up 18.16 points from the game, and the real winners from the result were the Lions after the Titans, who earned 5.5 points, failed to close the gap at the top of the table.
The visitors went into the final day on 144 for one with Dean Elgar and Henry Davids well set, but while the pair got through the first danger period of the day unscathed, they were unable to push on and score telling centuries.
The breakthrough was made by Stiaan van Zyl, who enhanced his reputation as something of a golden arm when he had Elgar caught behind for 79.
Davids fell to Paterson for 77 five overs later, before Van Zyl (2 for 28) struck again to remove Roelof van der Merwe cheaply.
The Titans rallied through an 82-run stand between Graeme van Buuren (59) and Qaasim Adams (40), but Paterson made the second new ball count by trapping both batsmen lbw and then ripping through the tail.
The Titans had looked in decent shape at 271 for four when the new ball was taken, but within 13 overs they were all out.
While it would take a minor miracle for the Cobras to come back and retain their trophy, with two home games at Newlands in the next two weeks they will back themselves to make up further ground on the teams above them in the table.