An ugly Royals season has taken yet another ugly turn.

Royals manager Matt Quatraro announced Tuesday that pitcher Cole Ragans likley will need surgery to repair a left elbow impingement that’s kept him sidelined since May 6.

The Royals skipper isn’t sure what type of surgery Ragans will need or whether he will return this season, but more will be known when the lefty sees another doctor soon.

“It’s awful,” Quatraro told reporters about the news. “We talk about it all the time when guys get hurt. These guys grind and work; and do it year-round to put themselves in the best position to go out there and compete.”

“Clearly, it’s a blow for him and for us. I mean, it’s our Opening Day starter the last few years. That’s a really tough one to swallow for him and his family,” Quatraro added.

Ragans exited a May 6 start against the Guardians with the injury, and though he made a rehab start for Triple-A Omaha in late May, he didn’t respond well and was shut down.

The elbow injury is just one of multiple injuries Ragans has suffered throughout his career, as he underwent Tommy John Surgery in 2018 and 2019 while with the Rangers.

The Royals acquired Ragans in 2023 in exchange for Aroldis Chapman, and the righty’s Royals tenure got off to a hot start.

Ragans posted a 2.64 ERA in 2023 and 3.14 ERA in 2024 while playing a pivotal role on the Royals 2024 squad that made the playoffs for the first time in nine years.

Since then, however, it’s been downhill for Ragans, as he recorded just a 4.67 ERA in 2025 and pitched to a 4.84 mark through eight starts in 2026.

The Royals entered 2026 hell-bent on competing for their first AL Central title in 11 years, but their season has turned into a disaster.

They are just 34-46 and last in the division entering Wednesday.