Top Red Sox pitching prospect Luis Perales will undergo Tommy John surgery next week, as was first reported by MassLive.com’s Chris Cotillo. The procedure will be performed by Dr. Jeffrey Dugas at the Andrews Sports Medicine & Orthopedics Center in Birmingham, Alabama.
Perales has been on Double-A Portland’s 7-day injured list since June 9 after leaving his start with elbow inflammation the night prior. As noted by Cotillo, the Red Sox were initially optimistic that the right-hander — who was in Boston for imaging late last week — was not dealing with a serious injury but an MRI revealed “significant damage” in the ulnar collateral ligament (UCL) of his pitching elbow.
Perales, 21, was in the midst of a breakout season after being added to Boston’s 40-man roster over the winter and taking part in his first big-league camp this spring. He opened the 2024 campaign at High-A Greenville, where he posted a 3.42 ERA and 2.04 FIP with 46 strikeouts to 10 walks in seven starts (26 1/3 innings) for the Drive.
After receiving a promotion to Portland in late May, Perales made his Double-A debut on June 2 and allowed just one unearned run while striking out seven over five innings. He took the mound for the Sea Dogs again at Hadlock Field six days later and yielded two runs (one earned) before departing with one out in the top of the third inning.
Altogether, Perales forged a 2.94 ERA (2.01 FIP) with 56 strikeouts to 12 walks in nine starts (33 2/3 innings) between Greenville and Portland this season. His 38.9 percent strikeout rate ranks eighth among 894 minor-leaguers who have pitched at least 30 innings to this point in the year, per FanGraphs.
A native of Venezuela, Perales originally signed with the Red Sox for $75,000 as an international free agent coming out of Guacara in July 2019. The 6-foot-1, 160-pound hurler is currently regarded by SoxProspects.com as the No. 4 prospect in Boston’s farm system, which ranks first among pitchers in the organization. Before getting hurt, Perales was making strides toward possibly being in the Sox’ major-league plans by next season. He was recently tabbed by Baseball America as the No. 57 prospect in the sport, marking the first time he has been included in the outlet’s top-100 rankings.
Now, Perales will miss the rest of 2024 and most — if not all — of 2025 while recovering and rehabbing from Tommy John surgery, which can be a grueling process. Since he is on the club’s 40-man roster, the Red Sox could recall Perales and place him on the 60-day injured list to free up a roster spot for someone else. That would, however, start his big-league service time clock.
Regardless of that though, it is worth noting — as SoxProspects.com Chris Hatfield did — that Perales will likely have burned through two of his three minor-league option years by the time he is ready to fully contribute in 2026. He could become eligible for a fourth option down the line, but that is not a given.
(Picture of Luis Perales: Elsa/Getty Images)
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