Injuries occur every NFL game, but on Thursday night, it was an official who suffered the most serious injury.
Adrian Hill, the referee working the Thursday night game between the Buffalo Bills and Houston Texans, had to be carted off the field after suffering a non-contact injury. Hill is a seven-year official who led the crew, announcing all the penalties to the crowd and audience.
The game had to be stopped as medical staff looked at Hill, ultimately deciding to pull him from the game. Here's a look at what happened to the lead official.
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NFL referee Adrian Hill injury
Hill appeared to suffer an injury away from the play in the third quarter as he came up limping while running to make a call. Medical staff came out to check on Hill and ended up helping him off the field, as Hill would eventually be carted off.
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
With Hill out, umpire Roy Ellison took over for Hill as the referee in the game. Ellison is a veteran official who has worked as an umpire since 2003.
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How many NFL refs per game?
Each NFL game has seven officials who all hold a different job, including:
- Referee
- Umpire
- Down Judge
- Line Judge
- Field Judge
- Side Judge
- Back Judge
The referee acts as the crew chief, announcing penalties to the crowd and audience throughout the game. If the referee can't go for whatever reason, the umpire would take over the referee's responsibilities.