Martin Necas had a goal and two assists, Jesperi Kotkaniemi also scored, and Andrei Svechnikov and Teuvo Teravainen each had two assists for the Hurricanes. Antti Raanta made 22 saves.
''It wasn't easy,'' Aho said. ''We scored a goal there pretty early and had the confidence going.''
Jacob Bryson, Victor Olofsson and Rasmus Dahlin scored for the Sabres, who had won three straight. Jack Quinn had two assists and Craig Anderson finished with 28 saves.
Unlike Carolina's previous three wins, this one was decided in regulation.
Aho scored the tying goal twice in the first period and had a chance to complete the hat trick later in the period on a short-handed breakaway, but the puck deflected off Anderson. Aho finished his fifth career hat trick with an empty-netter with 2:14 remaining.
''Every night it's pretty much the same,'' coach Rod Brind'Amour said of Aho's contributions. ''Elite players, that's how they go.''
The Sabres have won just once against the Hurricanes in the last 11 meetings (1-7-3). Despite a splendid opening stretch, Buffalo couldn't keep it going.
''We weren't as sharp tonight,'' Sabres coach Don Granato said. ''I would say there was a handful of guys who didn't look like themself.''
Still, this might have been a good barometer for a young Buffalo team trying to climb in the Eastern Conference.
''These are games you want to play,'' Granato said. ''Against top players in a building like this with the energy.''
Bryson opened the scoring when he was credited for a goal that bounced in off Svechnikov just 28 seconds into the game. It was Bryson's first goal of the season and marked Buffalo's first goal less than 30 seconds in since April 18, 2021, when Arttu Ruotsalainen found the net against Pittsburgh.
''It wasn't the best start by our line,'' Necas said.
Aho got the Hurricanes going when his shot from a difficult angle on the right side reached the net to tie it at 8:07.
Olofsson became just the seventh player in Sabres history to reach the nine-goal mark in the first 11 games on his conversion 10:06 into the game to give Buffalo a 2-1 lead.
''They had us on the ropes there early,'' Brind'Amour said. ''We were clearly not ready to go at that pace.''
Aho tied it again with a power-play goal with 7:15 left in the first - just 12 seconds into the man advantage.
Necas gave the Hurricanes a 3-2 lead at 4:07 of the second when he got a cross-crease pass from Aho and drilled a shot past Anderson.
Kotkaniemi gave Carolina a two-goal advantage when he got his first of the season at 9:22 of the third.
Dahlin capped the scoring on a power-play in the final second of the game.
Kotkaniemi and Dahlin, former first-round picks from the 2018 draft, tangled in a first-period scrum. Kotkaniemi landed a punch on Dahlin's face. That might have inspired Dahlin, who had game highs of eight shots on goal and three blocked shots.
''You're only going to stoke the competitive juice in him,'' Granato said.
Dahlin was the first overall selection in 2018. Kotkaniemi was third.
NOTHING FOR SKINNER
Sabres left wing Jeff Skinner, a former NHL Rookie of the Year with the Hurricanes, had six goals and four assists in seven previous career games against his former team. He was held off the scoresheet in this game.
Sabres: At Tampa Bay on Saturday night.
Hurricanes: Host Toronto on Sunday.
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