Nenad Vicinic's side will need to beat African champions Angola tomorrow morning (NZT) to have any chance of progressing to the quarter-finals of the 12-team tournament. They must finish in the top three to earn a ticket to London.
The Tall Blacks have appeared at the Olympics twice, in 2000 and 2004.
Veteran forward Casey Frank, who had five points and eight rebounds, said the fast start by Macedonia gave the Europeans confidence to take control of the game.
"We didn't have the aggressiveness from the start and once they got off to a good start...that gave them a lot of confidence," he said.
The Tall Blacks finished the game with a poor 21 turnovers and shot just 35 percent from the field.
"Our shooting let us down," Franks said. "When you shoot that poor a percentage it's always going to be difficult."
The Tall Blacks face a tall order to reach the next round, needing to make up a 26-point differential against Angola in just a 16-hour turnaround. Angola meanwhile will have a full day rest behind them.
"Obviously it's more difficult but it's the Olympic dream. We're certainly not going to give up on ourselves.
"We go into that game full of confidence. It's going to be difficult. We took a shot to the jaw today but we'll have to quickly recover as we play again within 24 hours," said Franks.
"We're going to have to dig down deep and find a way to get it done."
- HERALD ONLINE