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Royals anticipate surgery for Cole Ragans

Apr 8, 2026; Cleveland, Ohio, USA; Kansas City Royals starting pitcher Cole Ragans (55) talks to staff after being hit in the hand by a ball hit by Cleveland Guardians third baseman Jose Ramirez (not pictured) during the first inning at Progressive Field. Mandatory Credit: Ken Blaze-Imagn Images | Ken Blaze-Imagn Images

Don’t expect Cole Ragans back any time soon for the Royals.

The All-Star left-hander has been out since May 6 with elbow impingement, and the updated provided by manager Matt Quatraro today was not exactly encouraging with skipper indicated they expect Ragans will need elbow surgery. They will look to get a second opinion, but Quataro told reporters “we anticipate it being surgical.”

Ragans exited after just three innings in a start against the Guardians on May 6 with the elbow injury. He made one rehab for Triple-A Omaha in late May, but did not respond well afterwards and was shut down. The Royals sent him to get an MRI last week, but the results were inconclusive.

Ragans has twice had Tommy John surgery, which is used to treat a tear in the UCL, a ligament in the elbow. He had it first in 2018 when he was with the Rangers, and again in 2019. The latest elbow injury does not necessarily mean he has reinjured the UCL, but it is another setback for the 28-year-old. He missed three months last year with a left rotator cuff strain.

The Royals’ pitching staff is already facing injuries to Kris Bubic, Ryan Bergert, Carlos Estévez, and Nick Mears, and the Injured List now also features hitters Vinnie Pasquantino, Maikel Garcia, Jonathan India, and Kyle Isbel, with Bobby Witt Jr. out the last few days with a knee injury.

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