The singer fell onto the stage during her Dallas leg of the MDNA tour.
For many female celebrities, heels are a wardrobe staple.
But just like fame, performing in towering heels, is not without its ups and downs.
Madonna found out the hard way when she fell victim to her shoes and took a tumble on stage during a concert in Dallas.
The Queen of Pop, who is on her MDNA world tour, was performing her classic hit Like a Prayer when an overzealous fan grabbed her hand, causing her to lose her balance and fall face first.
In video footage posted on YouTube, Madge tumbles on to the stage floor waving her legs in the air.
Ever the professional, the Express Yourself hitmaker quickly rolls over and gets back on her feet. She even manages to continue singing throughout.
One viewer wrote: "I was at gallery and clearly saw a very excited fan who didn't let her go! But mdn [sic] being a pro acted like nothing happened."
Another said: "So what, she fell, she's still sold millions of albums and be richer than any who will watch this video on YT, including me... who wins?"
"She did recover well," another fan tweeted.
Earlier this year the 53-year-old star came under fire after exposing one of her breasts on stage. She also recently faced a backlash from fans when she used guns during a performance in Colorado, the state where a gunman shot dead 12 people during a Batman screening in July.
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