Spurs host Aston Villa on the back of a dreadful start to the 2026/27 season with no wins or goals scored from four Premier League games played so far.
De Zerbi's side was also dumped out of the Carabao Cup away at Liverpool in midweek, and the pressure is beginning to mount after a big-spending summer in north London.
Villa have fared slightly better - despite also failing to win a top-flight game up to this point in the campaign - but Unai Emery has enjoyed some relief with victories in the UEFA Champions League and Carabao Cup.
As De Zerbi chases a vital three points going into the international break, he's ready to roll the dice on Maddison, who has only played 35 Premier League minutes this season after an ACL tear in July 2025.
"(Pedro) Porro, (Sandro) Tonali, and James Maddison are all available to play," he told the media.
"James has been working with the team for the last 10, 15 days. And even if he's a technical player, he needs to be fit to stay in a good condition.
"When he arrives in the best condition, he's very important for us.
"As a personality, a character, a quality player, and an experienced one. The quality of his passes are different than the others."