The singer was performing a headline set at the American Airlines Center in Dallas on Saturday night (October 21) when she tumbled face first on stage.
The star was greeting fans during a rendition of 'Like A Prayer' when she stumbled forward on to the floor, but turned it into a roll and recovered to her feet.
Madonna has left a trail of controversy since embarking on her 'MDNA' world tour earlier this year.
The star was recently summoned to a Russian court for allegedly promoting gay rights at a gig in St Petersberg, and she was criticised for waving a gun on stage during her show in Denver after the recent shootings in nearby Aurora.
Photo gallery - Madonna's most controversial moments:
Copyright: Rex Features Everett Collection/Rex Features