Buffalo Bills' likely to escape Kansas City Chiefs' starting RB in Week 9

Chiefs' running back Isiah Pacheco is in danger of missing this Sunday's meeting with the rival Buffalo Bills.

Oct 12, 2025; Kansas City, Missouri, USA; Kansas City Chiefs running back Isiah Pacheco (10) runs the ball during the first half against the Detroit Lions at GEHA Field at Arrowhead Stadium. | Jay Biggerstaff-Imagn Images

In one of the Buffalo Bills’ most challenging matchups of the season, there is a distinct chance their opponent will be without its starting running back.

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Oct 27, 2025; Kansas City, Missouri, USA; Kansas City Chiefs tight end Travis Kelce (87) and running back Isiah Pacheco (10) celebrate after a play. | Denny Medley-Imagn Images

Pacheco likely out

Kansas City Chiefs RB Isiah Pacheco left this past Monday night’s game against the Washington Commanders due to a knee injury, which has left him considered week-to-week, per NFL Network’s Tom Pelissero.

Pelissero reported on Tuesday that Pacheco sustained an MCL injury, which has left his status for Sunday’s game in doubt.

Jan 26, 2025; Kansas City, MO, USA; Kansas City Chiefs running back Isiah Pacheco (10) reacts after the AFC Championship game against the Buffalo Bills at GEHA Field at Arrowhead Stadium. | Denny Medley-Imagn Images

Big loss?

Pacheco has led the team in carries and yards rushing through the first eight weeks of the season, totaling 78 carries for 329 yards rushing and a touchdown. He has also added 11 receptions for 43 yards and a score.

The four-year pro also dealt with injuries a season ago, causing him to miss Weeks 3 through 12, including a Week 11 matchup with the Bills. Pacheco was inactive for a 2023 meeting between the Bills and Chiefs but played during a 2022 tilt between the two teams, totaling two carries for nine yards and adding two receptions for nine yards.

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Oct 27, 2025; Kansas City, Missouri, USA; Kansas City Chiefs running back Kareem Hunt (29) speaks to the media after the game against the Washington Commanders at GEHA Field at Arrowhead Stadium. | Denny Medley-Imagn Images

Potential replacement

Before exiting his team’s win over the Commanders during the fourth quarter, Pacheco carried the ball 12 times for 58 yards. His backup, Kareem Hunt, finished the game with nine carries for 40 yards and a touchdown while adding a two-yard touchdown reception. Hunt has totaled 62 carries for 245 yards and four touchdowns rushing this season.

Oct 26, 2025; Charlotte, North Carolina, USA; Buffalo Bills defensive tackle Ed Oliver (91) reacts after a sack in the first quarter at Bank of America Stadium. | Bob Donnan-Imagn Images

How it impacts Bills

The Bills’ run defense has been porous this season, allowing 150.3 yards rushing per game, which is the second-most in the NFL. And while it got things together with an adequate effort against the Carolina Panthers, there remains cause for concern when it comes to this unit.

Buffalo is banged up at the defensive tackle position, with Ed Oliver, T.J. Sanders and DeWayne Carter on IR and DaQuan Jones on the mend. With Kansas City likely being without Pacheco, it’s one less option the Bills will have to worry about in the running game.

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