TL;DR
- Referee Adrian Hill suffered a non-contact injury during the Bills-Texans game.
- Hill, a seven-year veteran and crew chief, was carted off the field.
- Umpire Roy Ellison took over as referee after Hill's injury.
While injuries are common in every NFL game, an official sustained the most severe injury during Thursday night's contest.
Referee Adrian Hill, officiating the Thursday night matchup between the Buffalo Bills and Houston Texans, was removed from the field via cart following a non-contact injury. Hill, a seven-year veteran official, was the crew chief, responsible for announcing all infractions to attendees and viewers.
Hill was attended to by medical personnel, leading to his removal from the contest. Here's a recap of the incident involving the head referee.
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NFL referee Adrian Hill's injury
During the third quarter, Hill seemed to sustain an injury separate from the action on the field, as he began to limp while heading to make a play. Trainers attended to Hill and assisted him off the field, and he was later transported away on a cart.
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 official serves as the head official, informing spectators of infractions during the match. Should the official be unable to perform their duties, the substitute official would assume the role.