At ZERO1’s anniversary event at Ryogoku Sumo Hall in Tokyo, Otani challenged Pro Wrestling NOAH’s Takashi Sugiura for the ZERO1 World Heavyweight Championship, with Otani looking to bring the title back to his home company. In the closing stages of the match, Sugiura delivered a German Suplex to Otani into the turnbuckle from which Otani didn’t get up. The match was thrown out and fans were asked to leave the venue so Otani could be transported to a hospital. Some reports indicate Otani was conscious and talking to the referee while in the ring but was unable to move his limbs, while others suggest he was unconscious until he arrived at the hospital; the one thing that was consistent through all of the reports was that Otani had suffered a cervical spinal injury, and was paralyzed from the neck down. Otani underwent successful surgery a few days later and was transferred to another facility, where he would begin his rehabilitation.

It’s been over three years since the in-ring accident, and while Otani still remains paralyzed from the neck down, he has remained in high spirits and still regularly posts on social media. One year on from his injury, ZERO1 named a number of their April dates “Ganbare! Shinjiro Otani!!” Ganbare roughly translates from Japanese to English as “Do Your Best” or “Come On,” and in May 2023, Otani made a special appearance at a ZERO1 event where he was able to address the fans about his future, and received a bouquet of flowers from the man who injured him, Takashi Sugiura, with Otani promising that the two men would wrestle again, and that he would be the one to win the rematch.