Round 1 Riding a wave of support and political capital Miliband asks whether the government will disclose the names of all executives who earn over £1m.
Cameron is immediately on the back foot and remains there for the rest of the PMQs with Miliband. He puts up a mask telling the Commons that the government has introduced tough rules on bankers' pay al-ready. But's it's a weak throw and Miliband lands his first punch.
Winner: Miliband
Round 2 Miliband tries to force home the issue of high executive pay. He tells Cameron that the chancellor, George Osborne, broke a promise to implement the Walker report recommendations on publishing executive pay figures.
Cameron anticipates the jab and comes back with a strong counter-punch reminding Miliband that it was he who gave the RBS a bonus pool of £1.3bn. Cameron says: "Why is [Mliband] advocating things he did not support when he was in government? Some would call that 'hypocrisy'." Nice move from the PM.
Round 3 Unphased and back on his feet in a flash, Miliband pulls another ace. Reminding Cameron of the last few troubled days, he says hypocrisy is saying that you will block a £1m bonus for Stephen Hester and then nodding it through.
Cameron, again on the canvas, tries to blame Labour again for presiding over big bonuses. This defence is wearing thin on both the public and the opposition benches. He must realise that he is prime minister and makes the calls.
Winner: Miliband
Round 4 Perhaps a question too many here for Miliband who unnecessarily criticises the chancellor telling businesses to lobby against the 50p tax rate in Davos.
Cameron takes advantage saying that Miliband was in Davos too. "But Peter Mandelson had a word for Miliband in Davos. It was struggling".
Winner: Cameron
Round 5 Miliband turns to the NHS reforms and quotes three leading medical publications who disagree with the changes. "Why has Cameron lost the trust of the medical profession?" he asks.
Trying to avoid the punch, Cameron swerves and asks: "Interesting he's not mentioned the Welfare Bill." Not funny or cool approach there. Cameron claims doctors are already implementing the changes.
Winner: Miliband
Round 6 Arguably Miliband's finest moment in PMQs as he lists groups and royal colleges who oppose the bill. Labour MPs chant:"Against the bill." It's the kind of thing Cameron used to do when he was Leader of the Opposition - and look where he is now.
Cameron embarrassingly reads a quote from Tony Blair to back up his argument that the reforms are necessary. It's a last throw from a tired fighter who knows he's done.