What Happens When a Referee Gets Hurt During an NFL Game? Latest on Adrian Hill After Exiting Bills-Texans
Referees in any sport have a ridiculously tough job to do. While it becomes easy to criticize and break down each decision with the comfort of replay technology and slow motion, the officials have to make game-deciding decisions in brutally tight windows. But the job is made all the more difficult in a contact-heavy, physical league like the NFL.
Unfortunately, sometimes that roughness comes into contact with the referees themselves. The league has to keep that in mind and has designated rules in place when an official is taken out of the game, as fans witnessed during the Buffalo Bills-Houston Texans game in Week 12 on Thursday Night Football.
Protocol When a Referee Gets Hurt in the NFL
During the third quarter of the game between the Bills and the Texans, fans were treated to an unusual sight, and no, we’re not talking about the fact that Davis Mills was outplaying Josh Allen at the quarterback position.
Referee Adrian Hill, who has been in the NFL since 2010, is one of the most highly tenured officials in the entire league. Starting his officiating career in college football in 2004, he transitioned to the pros in 2010, where he held positions including side judge, field judge, and line judge over the years.
Finally, he was promoted to the referee spot in 2019 and has become a tried and tested name for the league. However, on Thursday Night, he was the victim of an unfortunate accident, with no one’s fault.
Status alert: Referee Adrian Hill (leg) improbable to return Thursday.pic.twitter.com/NTvfQ3vgCx https://t.co/A8QgtDRMl6
— Underdog NFL (@UnderdogNFL) November 21, 2025
Standing in the end zone, he started to run towards the line of scrimmage. But he immediately started limping as he suffered a non-contact injury on his leg. Soon after, he was carted off the field.
For many fans, the immediate question was, What comes next? Well, the answer is relatively simple when it comes to the NFL. In the case of a referee going down during a regular-season game, the league does not appoint any alternatives.
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Instead, the rest of the crew continues with six-man mechanics. Typically, that results in the back judge position being sacrificed, but it can depend on the personnel in the crew. Moving forward, depending on the severity of Hill’s injury, the NFL has two major options to overcome his absence.
Either they can use swing officials, veterans who can adjust to any crew in a given week. Alternatively, they can utilize creative scheduling to slot in an official on a bye week to fill in for the injured referee, or ask an already assigned referee, typically on an MNF or TNF game, to work double duty during the week.
