After blowing a two-shot lead on the 317-yard hole in regulation when he blasted a driver through the green and into the water, Fowler pulled a 5-wood into the lake on the fourth hole of a playoff to set up the deciding bogey. Matsuyama birdied the hole in regulation and two-putted for par from 6 feet in the playoff.
Fowler forced the playoff with a 10-foot birdie putt on the par-4 18th after Matsuyama made an 18-footer. They each shot 4-under 67 to finish at 14-under 270.
Matsuyama won the 2014 Memorial for his only other PGA Tour title, beating Kevin Na on the first extra hole. The 23-year-old Japanese player tied for second last year at TPC Scottsdale, a stroke behind Brooks Koepka.