Mosimane, who was joined by his newly-appointed assistant coach Cavin Johnson for the first time, recalled Amr Al-Sulaya and Mahmoud Kahraba with Marwan Mohsen unavailable.
Kahraba's time on the field lasted only 12 minutes when he pulled up injured and was duly removed for fellow striker Aliou Badj.
It was also the third consecutive time where Mosimane had to turn to his bench early in the first half and remove players succumbing to various injuries.
Pyramids made the bright start after a ball from Mohamed Hamdi in the penalty area connected with Mohamed Farouk, whose pin-point header shaved the post.
The away side had the ball in the back of the net just before halftime through Ahmed Mansour, but it was disallowed for offside after consultation with the Video Assistant Referee (VAR).
Ahly were on the receiving end of a dismissal three minutes to the break through Al-Sulaya who walked the plank for an indiscretion.
The Red Devils should've gone to halftime leading, but were denied after El Mahdy Soliman smothered Mohamed Magdy from the penalty spot following a foul in the six-yard area.
Mosimane turned to the substitutes' bench for the second time in the match at halftime as Badji made way for Ahmed El Sheikh.
Pyramids missed a big chance to go ahead ten minutes from the interval after substitute Ibrahim Hassan struck the left-hand post with a thumping shot.
Both sides looked for the winner in the remaining stages of the match, but were forced to settle for a point apiece in Cairo.
