Suzuki missed the past three games while dealing with a hip flexor strain. The 36-year-old, who homered in Game 2, was initially listed in the starting lineup but was replaced again by Yan Gomes just under three hours before the first pitch.
So Gomes instead of Suzuki will be behind the plate for Max Scherzer, the three-time Cy Young winner who was unable to make his start in Game 5 because of an irritated nerve near his neck. Scherzer is starting the finale after receiving a painkilling cortisone shot.
Gomes was listed eighth, the same spot Suzuki was to bat, and center fielder Victor Robles hit ninth. They were reversed for Game 6 that Washington won.
Houston used a familiar lineup against the right-hander, led off by 2017 World Series MVP George Springer.
Nationals manager Dave Martinez said Scherzer has told him that he feels great and is ready to go. He was later seen throwing in the bullpen during that game Tuesday night.
"He's going to go, he's going to pitch," Martinez said before the deciding game Wednesday night. "We'll see how far he will take us.''
Astros manager AJ Hinch said Game 6 starter Justin Verlander won't be available for Game 7. After taking the loss in Game 6 to fall to 0-6 in seven career World Series starts, Verlander said he would be available on Wednesday if Hinch needed him. But Hinch shut that down.
"All hands on deck means most hands on deck," Hinch said.
While Verlander is out, fellow ace Gerrit Cole could be used out of the bullpen. Cole got the win in Game 5 on Sunday. Hinch said he'll talk to him before the game about how he might use him on Wednesday.
"It would be in a limited capacity if I ask him to do anything," Hinch said.