Josiah Harrell’s Impossible Comeback: Overcoming Brain Disease to UFC Debut

Last Updated on February 22, 2026 by Pragjyoti Singh

While a call from the UFC is usually a dream come true for a fighter, for Josiah Harrell, it proved to be the exact opposite ahead of UFC 290. The 27-year-old was set to face Australia’s Jack Della Maddalena in 2023, but a last-minute medical issue, the details of which were kept under wraps at the time, forced him to withdraw from the bout.

Reports later came out that Harrell, after the mandatory pre-fight MRI scan, was suffering from a rare brain disease. His manager later revealed that the fighter would have to undergo surgery to address the medical concern.

After a remarkable recovery and a complete career turnaround, Harrell is stepping in on short notice to face Jacobe Smith at UFC Houston. He joins a high-stakes card headlined by Sean Strickland and Anthony Hernandez, featuring other standout matchups like Dan Ige versus Melquizael Costa.

Josiah Harrell was diagnosed with Moyamoya, a rare Brain Condition

Josiah Harrell says he has already made peace with the idea of fighting with a rare disease.

“Some people are scared to die, I guess. If I do, then I get to be with the Lord,” he told the press before his fight against Smith.

That statement perfectly captures the man Harrell has become, evolving through an experience that would have easily ended the career of a lesser athlete, emerging stronger on the other side.

In July 2023, Harrell learned he was suffering from Moyamoya, a rare and progressive cerebrovascular disorder where the internal carotid arteries at the base of the brain narrow, restricting blood flow. Although the exact causes of the disease are unknown, it is often linked to genetic factors and could lead to permanent brain damage if left untreated.

For Harrell, it came right before his UFC dream was about to come true. Scheduled to face Jack Della Maddalena, who would later go on to become welterweight champ before his eventual loss to Islam Makhachev, Harrell’s world came crashing down after the UFC 290 weigh-ins. He was eventually removed from the card and the promotion too, shortly after that.

Showing true grit, Harrell was back on his feet just one day after the surgery and immediately hit the gym. Unfortunately, he ended up suffering two seizures, forcing him to take a step back and reevaluate his health.

“I was focused on staying on the path, giving all glory to God, and continuing on my way”, Harrell recently said.

Post his recovery, the ‘Muscle Hamster’ went on a tear, racking up four consecutive stoppage wins on the regional circuit. That dominant run propelled him back to the big stage, carrying a perfect 11-0 record into his UFC debut.

Amid his intense health struggle, Harrell credits Vince Murdock of Team Alpha Male as someone who played a big role in his return. Murdock, a former professional fighter, also underwent surgery for Moyamoya, reached out to Harrell to lend support.

“He made a way for it, and that gave me the hope that I needed to keep going and not beat myself up too much. This is just as much a mental game as it is a physical game. It was nice to be able to have someone other than the Lord to lean on,” Harrell told the UFC.

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Jacobe Smith vs Josiah Harrell Prediction

Jacobe Smith enters the fight as one of the biggest favorites on the card at -298 to Harrell’s +240. Physically, the two welterweights are nearly identical, both standing 5’10” and hitting the 171-pound limit. However, the tale of the tape reveals a significant hurdle for Harrell: Smith holds a commanding 72-inch reach, giving him a five-inch advantage over the ‘Muscle Hamster’s’ 67-inch wingspan.

While Smith may be the safer pick, it’s impossible to ignore Harrell’s finishing rate. Out of his 11 professional wins, the undefeated prospect has stopped 10 of his opponents.