Josiah Harrell’s Remarkable Return to the UFC After Battling Moyamoya Disease

Josiah Harrell, a welterweight mixed martial artist, is set to compete at UFC Fight Night: Strickland vs. Hernandez on February 21, 2026, marking a triumphant return to the Octagon after overcoming a life-threatening brain condition. His story is one of resilience, determination, and a relentless pursuit of a dream deferred.

A Promising Career Interrupted

Harrell initially signed with the UFC in July 2023, receiving a last-minute call to face Jack Della Maddalena at UFC 290. However, pre-fight medical testing revealed a rare and serious brain disease, forcing him to withdraw from the bout and halting his UFC debut [1].

Diagnosis and Surgery for Moyamoya Disease

Harrell was diagnosed with Moyamoya disease, a progressive cerebrovascular disorder characterized by blocked arteries at the base of the brain. This condition can lead to strokes and blood clots [1]. He underwent complex brain surgery in 2024 to reroute blood flow and prevent further complications [2]. The surgery involved creating a latest pathway for blood to reach the brain, a procedure described as drilling a hole through his skull to thread a vein [2].

Comeback on the Regional Scene

Following his recovery, Harrell was released from the UFC organization. Undeterred, he vowed to return to the sport and continued training. In March 2025, less than two years after his surgery, he resumed his professional fighting career on the regional circuit, securing a second-round TKO victory [3]. He continued his winning streak, going 4-0 with three finishes in the Ohio Combat League and one in the LFA, improving his overall record to 11-0 [1].

Second Chance in the UFC

On February 13, 2026, the UFC announced that Harrell had been re-signed to the promotion. He will replace the injured Seok Hyun Ko and face Jacobe Smith at UFC Fight Night: Strickland vs. Hernandez on February 21, 2026, in Houston, Texas [3], [2]. This opportunity came after Seok Hyeon Ko withdrew due to a rib injury [3].

Facing a Formidable Opponent

Harrell will be facing Jacobe Smith (11-0 MMA, 2-0 UFC), a highly-regarded welterweight prospect known for his wrestling background and finishing ability [1].

A Testament to Perseverance

Josiah Harrell’s journey is a powerful example of overcoming adversity and pursuing one’s passion. His return to the UFC is not just a comeback for a fighter, but a testament to the human spirit and the power of determination.