Things have changed for Josiah Harrell. There's been a lot of bad, and some low lows.

But with clarity obtained, the faith built, and the perspective adjusted, Harrell (9-0) thinks he's ready for his second (or first) UFC crack, depending on how you look at it.

"I feel like once they give me a chance, good things will happen in the welterweight division," Harrell recently told MMA Junkie.

Harrell was onboarded onto the UFC roster in July 2023 for a short-notice bout vs. then-surging contender Jack Della Maddalena. The mental noise and mixed emotions that came with the UFC call and rushing to get all pre-fight necessities done were mute when his medicals came back and showed a rare brain abnormality. Harrell was diagnosed with Moyamoya disease and pulled from the bout.

Moyamoya is a rare disease in which brain arteries are narrowed, reducing blood flow and increasing the likelihood of stroke. Harrell is shocked that he never suffered a fatal incident prior to the Moyamoya discovery, when his susceptibility was heightened.

"Just doing the math and the probability that me being in combat sports my whole life and dealing with football and understanding how close I was to death for who knows, probably pretty much my whole life around anything that raises blood pressure: sex, alcohol, drugs, anything that put me unconscious," Harrell said. "I've been unconscious in football and we used to play this knockout game as a kid, which we thought was fun. Anything that put me unconscious was an increased stroke probability. Any time that I had stress or anything that can cause strokes. Pretty much my whole life I should've had a stroke or two while I was sleeping."

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Going through the experience has refocused Harrell existentially and spiritually. He recently made the decision to get baptized, as his faith in God has been reaffirmed.

"It's just hard for me to have a brain that wants to look for things or signs of things that can help me with life and then go and see how many times I should've been put out or I should've stroked out when I wasn't conscious or do all that and look up and not go, 'Thank you,'" Harrell said.

In January 2024, Harrell underwent brain surgery to fix the issue. The procedure was successful, and Harrell was eventually granted clearance to fight again. He says he has no medical restrictions. While he battled back to become a professional athlete again, the stigma that comes with having a brain procedure in the fighting community has been a bit more challenging to defeat.

Harrell was booked to fight in LFA in October, but the bout was yanked at the last minute as New York does not permit those with a history of brain issues to compete. Harrell's native Ohio, however, allowed his long-awaited return in March as he defeated Quinton Parks Jr. by second-round TKO. He then defeated UFC alum Melvin Guillard by first-round submission in May.

"Obviously, I dealt with a lot of unknowns dealing with the brain surgery, and the problems with commissions or states being like, 'Yeah, I don't know if you can do this, or I don't know if we should let you,'" Harrell said. "It was pretty much a state of fear that everybody else was in. I'm just pretty much like, 'Give me a chance.' It was the same thing with the UFC. I feel like once they give me a chance, good things will happen in the welterweight division."

"… We shouldn't have that many issues. We've already had Ohio check us off and we fought in Ohio already. We've already had Kentucky check us off. I fought twice in the last four months. It's not like, 'Oh, you can't fight anybody.' Nope. We've shown here and here and here, that not only can I fight but I can perform and do what I need to do so you guys don't have to worry too much about what ifs. It's like as long as we check the boxes of being physically fit or the doctors that they have check me off on being able to compete, it should be nothing to do with the brain. It should have nothing to do with my brain. It should only have to do with my eyes or my physical or whatever. As long as I'm physically fit to fight or physically capable of fighting, we should be good to go."

If you’re wondering, Josiah Harrell ran through Melvin Guillard tonight https://t.co/xC0a2sqd4xpic.twitter.com/4IFo6Hyfem

— Alex Behunin (@AlexBehunin) May 18, 2025

As history shows, other states – and the UFC – have been open to individuals with Moyamoya fighting post-procedure. Vince Murdock was in nearly an identical situation to Harrell in 2019, and went on to compete on "The Ultimate Fighter" and Dana White's Contender Series.

Now managed by his coach and mentor, Matt Brown, Harrell likes his odds that a UFC call will come after his next fight, which takes place Aug. 2 vs. Kegan Greenich (9-4) at Ohio Combat League 39.

"Matt Brown reached out to the UFC just because he has a lot of connections to Sean (Shelby) and all those guys, so he's been talking to them," Harrell said. "We're just waiting to hear back on their end. … I'm just like, let's push. Let's get the best fights we can, which is scary for a lot of people because they're like, 'Well, I'm one or two away from getting a chance or getting to the Contender Series.' I'm like, 'Who gives a f*ck about Contender Series or a chance?' I'm like, let's keep going. Let's fight the best we can. Whoever is going and winning will get that opportunity. Let's not try to hold back because we are doing well. I think too many people are concerned about being undefeated or having a great record or whatever it is. I'm concerned about being the best I can be. That doesn't happen unless I can push myself."

Harrell, 26, feels his UFC tale is far from complete. The possibility he could've changed the course of UFC history vs. a then-rising Della Maddalena (18-2 MMA, 8-0 UFC) has him hungry to see how things would actually play out if he stepped inside the promotion's cage.

"I think people forget how hard it is to fight shorter people, especially if you're not used to it," Harrell said. "So me being shorter (5-foot-7) than most of those guys, I'm a problem with those guys. Even with Islam (Makhachev) coming in, that's a tough fight, as well. It's stuff where you obviously have to game plan and make sure I'm there.

"But from Islam to Shavkat (Rakhmonov) to Jack to even Belal (Muhammad) and Sean Brady, it's like I match up well with a lot of those guys and I haven't had to show my boxing. I showed it a little bit in the Robertson fight but that was just because I wanted to stand up with him and have some fun. But it's like I don't have to. That's the thing. I'm not just a grappler. I'm not just a striker. I'm there to change at the drop of a dime if I need to. A lot of us just need to be having fun."

This article originally appeared on MMA Junkie: UFC signee who underwent life-saving brain surgery hopes to return

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