James Cook's fumbling issues become impossible to ignore despite Bills' 'MNF' win over Rams

Few running backs are better when they get hot than James Cook, who has anchored the Bills' rushing attack since Joe Brady started calling plays in 2023.

If there is one drawback, though, it's ball security. Cook fumbled six times in 2025, more than any other running back, and fumbles came back to haunt him again on Monday night despite the Bills pulling off a 37-34 overtime win.

Cook's second fumble of the night turned a Bills scoring opportunity into a fruitless possession, setting up a Rams drive that nearly ended the game.

Here's a look at Cook's critical fumble and why it isn't just a one-off mistake.

James Cook fumble vs. Rams

Cook had two balls punched out on Monday night, including one recovered by his team in the third quarter that looked like it could've been anyone's all.

While the Bills could breathe a sigh of relief after that fumble, they could only hang their head after Cook's second fumble, which came with Buffalo in field goal range and driving in overtime.

NATE LANDMAN PEANUT PUNCH!!! 📺 @ESPNNFL | #RamsHouse https://t.co/2S1rKhnRp8

Cook coughed up the ball on a punch-out by Nate Landman, right after a huge catch-and-run by Khalil Shakir nearly ended up in the end zone. That seemingly set up the Rams to win the game, with L.A. reaching Harrison Mevis' field goal range, but Mevis' 48-yard attempt was blocked. Buffalo would snag the win anyway, taking some of the pressure off the running back.

Cook was bailed out by the Bills' special teams success, but the numbers say Buffalo's offense has a problem.

James Cook fumbles in 2026

Cook now has four fumbles, including two lost, through five games this season, more than any other player in the NFL. 

In 2025, Cook led all running backs with six fumbles, finishing the season tied with Josh Allen and trailing only Caleb Williams.

Since the start of 2025, that puts Cook far ahead of the rest of the pack in terms of fumbles, as he's doubling up every running back other than Bijan Robinson.

Most fumbles among RB since last season James Cook 10 Bijan Robinson 7 Cam Skattebo 5 Jonathan Taylor 5 Derrick Henry 5 https://t.co/BedQqnNs0F

While Allen's interceptions have been at the center of the conversation about the Bills' turnover troubles, Cook's fumbles are becoming nearly as much of an issue for Buffalo even with the team sitting pretty at 4-1.