Iowa State Star Joshua Jefferson Exits Game With Injury

The Iowa State Cyclones entered the 2026 NCAA Tournament with high expectations after earning the No. 2 seed in the Midwest Region with a 27-7 record.

They were set to face off against the Tennessee State Tigers, the automatic qualifier from the Ohio Valley Conference, who are the No. 15 seed. What was such an exciting time for the Cyclones quickly turned disastrous.

Not even three minutes into their Round of 64 game, their star forward, Joshua Jefferson, suffered what looked to be a serious ankle injury after driving to the basket for a layup. He stayed on the ground for a little while before being helped off the court and into the locker room.

It was a brutal visual as he was helped to the back. He couldn’t put any pressure on his injured ankle, hopping to the locker room with assistance from two people.

Joshua Jefferson suffers brutal ankle injury against Tennessee State

Iowa State Cyclones forward Joshua Jefferson shooting layup. — Mar 20, 2026; St. Louis, MO, USA; Iowa State Cyclones forward Joshua Jefferson (5) shoots a layup against Tennessee State Tigers forwards Antoine Lorick III (11) and Jalen Pitre (0) during the first half of a first round game of the men's 2026 NCAA Tournament at Enterprise Center. | Jeff Curry-Imagn Images

During the telecast, college basketball insider Jon Rothstein shared an update that Jefferson was undergoing X-rays right away in the back. In a later update, it was revealed that he is considered doubtful to return. He was shown needing crutches to get into the team’s locker room as well.

Without Jefferson in the mix, head coach T.J. Otzelberger looks to be turning to Dominick Nelson off the bench to take up some of the minutes that would normally go to his star forward. The transfer from the Utah Valley Wolverines has not been part of the rotation for months.

He was in the mix during the non-conference schedule, but saw his role diminish as the season moved along. Since the calendar flipped to December, he has received double-digit minutes of action twice, with the last time coming back on Jan. 13 against the Kansas Jayhawks in an 84-63 loss.

Iowa’s State’s Joshua Jefferson is unable to put any weight on his left leg/ankle.

He’s headed back to the locker room. pic.twitter.com/UpDkFj6h6D
— Ben Hutchens (@Ben_Hutchens_) March 20, 2026

If Jefferson’s injury is as serious as it looks, the Cyclones are going to be without their star player for the foreseeable future. It certainly didn’t look like he would be returning to the court any time soon, with how much help he needed getting off the hardwood.

His loss is a considerable one for Iowa State. He has stuffed the stat sheet this season, averaging 16.9 points, 7.6 rebounds, 4.9 assists, 1.7 steals and 0.9 blocks in 31.8 minutes per game.

The points, rebounds, assists and minutes played are all single-season highs for Jefferson. Replacing that kind of production will not be easy and will require a complete team effort to replace their star forward.