Royals ace Cole Ragans to undergo elbow surgery on July 1, extent of damage still unknown
The Kansas City Royals left-hander will go under the knife after a left elbow impingement sidelined him in early May. Doctors say the MRI is inconclusive; they will determine the full repair plan only once the procedure is underway.
Injury timeline
Cole Ragans has not pitched in a major-league game since May 6, when he left a start against the Cleveland Guardians after just three innings. The initial diagnosis was valgus extension overload of the left elbow, and he was placed on the 15-day injured list two days later. A rehab outing for Triple-A Omaha on May 24 did not go well; his elbow did not respond as hoped, and the Royals moved him to the 60-day IL on June 17.
- Leaves start against Cleveland after three innings; later diagnosed with valgus extension overload
- Placed on 15-day injured list with left elbow impingement
- Makes one rehab start for Triple-A Omaha; elbow does not respond well
- Transferred to 60-day injured list
- Scheduled elbow surgery performed by Dr. Neal ElAttrache
Surgery and uncertainty
Ragans will undergo the operation on Wednesday, July 1, with orthopedic surgeon Dr. Neal ElAttrache performing the procedure. The team has stressed that the full scope of the damage remains unclear despite an MRI exam.
They've read the MRI, but I think they're not going to be clear on the extent of (the surgery) until they get in there and understand what they see.
The timetable for Ragans' return will not be set until ElAttrache assesses the joint during surgery.
Ragans' 2026 season
The 2024 All-Star, who served as the Royals' Opening Day starter for the third straight year, posted a 1-4 record with a 4.84 ERA in eight starts this season. His year included several dominant outings, such as a six-inning, one-hit performance at Detroit on April 14, but also two starts in which he allowed more runs than innings pitched.
Career context
Across 91 major-league appearances (74 starts) with Kansas City and Texas, Ragans carries a 22-24 record and a 3.76 ERA. He has averaged 10.86 strikeouts per nine innings, totaling 506 strikeouts in 419 1/3 innings. The 2016 first-round draft pick missed most of the 2025 season because of a left groin strain and rotator cuff strains. Ragans has already undergone Tommy John surgery twice during his time in the Rangers organization, making the outcome of this latest elbow procedure a critical moment for his career.
