Madonna was performing at the American Airlines centre in Dallas when a fan pulled too hard at her hand, causing her to fall. Watch a video of the incident below.
The singer was performing in Dallas on Saturday as part of the MDNA tour, and was greeting fans during her rendition of 'Like A Prayer'.
She kneeled down to grasp their hands and allow them to join in, but one fan didn't let go and Madonna ended up stumbling forward.
Madonna turned it into a roll on her back before recovering and standing up to carry on with the song.
Madonna: thankfully upright while performing on the MDNA tour
Madonna's MDNA tour hasn't been going so well, lately. Falls aside, the singer was recently issued with a lawsuit for encouraging gay sex in Russia. Members of the Trade Union of Russian Citizens are claiming more than £6million in compensation for "moral damages" caused by the concert, and are accusing Madonna of blasphemy and damaging the cultural foundations of Saint Petersburg.
Darya Dedova, a Union spokesperson, said: "She insulted believers' feelings, she promoted homosexuality when there were children at the concert and this is forbidden in St Petersburg. We, the residents of the cultural capital, suffered a colossal moral damage."
The lawsuit orders Madonna to defend the comments she made - which were reported as being: "Show your love and appreciation to the gay community. We want to fight for the right to be free."
Watch the video of Madonna's fall below:
Below, check out the photos of Madonna's first concert of MDNA