Evenly matched Group F encounter could well end in stalemate.
Winger Miroslav Stoch is tipped to start for Slovakia after recovering from a minor knee injury.
Stanislav Sestak was used as a midfielder against New Zealand but is expected to play up front on Sunday, with Erik Jendrisek dropping to the bench.
Paraguay coach Gerardo Martino is likely to deploy a three-man attack, which could mean Roque Santa Cruz starts. The Manchester City striker, who has a muscle problem, came off the bench against Italy.
Aureliano Torres is set to drop out of the starting XI, while midfielder Jonathan Santana is struggling with a thigh problem.
One booking from suspension: Strba (Slovakia), Victor Caceres (Paraguay) (BBC Sport)
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Whilst Slovakia will have been disappointed with the manner in which they dropped two points against New Zealand the draw between Italy and Paraguay keeps the group fairly open. The South American side were well worth their point against the reigning World Cup holders and will go into this Bloemfontein with renewed confidence.
Highlights of previous World Cup group games the two sides have taken part in.
New Zealand 1-1 Slovakia
Italy 1-1 Paraguay