An unexpected scene unfolded during Thursday Night Football when longtime NFL referee Adrian Hill suffered a sudden left leg injury in the third quarter of the Buffalo Bills and Houston Texans matchup. The moment shifted the tone of the game as medical staff rushed in and the officiating crew adjusted on the fly.
NFL Ref Adrian Hill Carted Off After Mysterious Non-Contact Injury During Bills-Texans ‘TNF’ Matchup [VIDEO] (Image via X/MySportsUpdate)
NFL Ref Adrian Hill Carted Off After Mysterious Non-Contact Injury During Bills-Texans ‘TNF’ Matchup [VIDEO]
(Image via X/MySportsUpdate)
Hill, known for his steady presence and long experience, tried to jog through the play before collapsing in pain, creating instant concern across the field.
Adrian Hill leaves game with injury as Roy Ellison takes over
The injury happened with 7:29 left in the third quarter. Hill followed the play toward the end zone, but his stride stopped suddenly. He grabbed his left leg and leaned forward as the players moved past him.
No one made contact with him. He was alone in the corner of the end zonewhen the injury occurred, which made the moment even more surprising to the broadcast crew.
Referee Adrian Hill in the #Bills–#Texans game suffered a non-contact injury and had to be carted off. pic.twitter.com/6zTHla9eN2
— Ari Meirov (@MySportsUpdate) November 21, 2025
Texans medical staff hurried over. Hill tried to stand for a moment but struggled, so acart was called from the tunnel.
NFL ref Adrian Hill is carted off with a leg injury during the Bills-Texans TNF game. #NFL pic.twitter.com/7HlPkaJhTs
— Awful Announcing (@awfulannouncing) November 21, 2025
Before leaving, he took off his white referee hat and handed it to umpire Roy Ellison. That small handoff signaled a complete shift in control.
Ellison stepped into the referee role for the rest of the night. The crew continued with six officials instead of the originally planned seven.
Prime Video rules analyst Terry McAulay explained the change on-air. McAulay said Ellison now had to “cover the entire offensive backfield by himself,” which changed the workload and angles for the whole unit.
Fans noticed the adjustment right away. Several plays felt slower as the officials found new positions. The commentary focused on how the altered formation affected spotting and penalty decisions.
Hill has been part of the league since 2010. He earned his promotion to referee in 2019 after years as a side judge, field judge and line judge.
His career started much earlier. Hill began officiating college football in 2004 after earning degrees in aerospace engineering. He studied at the University at Buffalo and later completed a master’s program at Johns Hopkins University.
He also worked in NFL Europe before it folded, building the experience that helped him transition to the NFL.
Hill has been assigned playoff games regularly.Per Pro Football Reference, he has usually received at least one postseason matchup each season. His most recent appearance was in the 2023 Buccaneers-Eagles Wild Card game.
Due to his reputation for consistency, the injury generated an instant online conversation. Some fans wondered how long he might be out. Others focused on how unusual it is to lose a referee midgame without contact.
There was still no immediate update after he left for testing. The league is expected toreview the situation and determine how quickly he can return to conduct the play.
For the remainder of the night, the game continued under Ellison’s direction, leaving viewers hoping Hill recovers soon.