Krejcikova battles back from brink to win at Australian Open
The Czech ninth seed, who triumphed at Roland Garros in 2021, struggled with her serve on Margaret Court Arena and was broken six times in total by her 122nd-ranked opponent.
But she dug deep when trailing 3-1 in the second set after losing the opener and eventually turned the tables.
Hontama, 24, playing in just her second Grand Slam, broke twice in the opening set to take a grip on the match.
There were multiple breaks in the second set but Krejcikova produced a powerful forehand winner to hold in the ninth game and edge ahead 5-4, seizing her chance to level the match.
The Czech player, 28, needed a medical timeout when 3-2 up in the decider, receiving heavy strapping to her foot and ankle.
But she showed no signs of discomfort as she returned to the court, conjuring a crucial break in a long eighth game to leave her on the brink of victory, which she sealed when Hontama went long with a forehand.
Krejcikova said she was relieved to get through a "difficult match", which lasted 2hrs 30mins.
"I just tried to stay in the match," she said. "In the second set I was down but I never let go and I never gave up."