The brawl began with 45.9 seconds remaining in the final quarter of the game, when the Pacers led 97–82. Pistons center Ben Wallace was fouled from behind by Artest, who slapped him across the back of the head during a layup attempt. Wallace later said that Artest had warned him he would be hit. Wallace responded by shoving Artest in the face with both hands, causing players from both teams to quickly get in between them as they attempted to keep the two separated.
Pistons coach Larry Brown later said he was initially not concerned, because when altercations occur in NBA games, they usually last a few seconds. After breaking up the confrontation, referees discussed fouls and ejections before the game resumed. Sportscaster Mike Breen, calling the game for ESPN, believed Wallace would be ejected, while Bill Walton was of the opinion that Stephen Jackson should be ejected as well for shouting at the Pistons players and aggravating the situation. However, Breen expressed concern that, if Wallace got ejected, he would have to walk past the Pacers bench, which could have caused another incident.
As the referees huddled to discuss penalties, Artest went to the scorer's table and laid down on it, putting on a headset to speak with Pacers radio broadcaster Mark Boyle, though the broadcast team did not activate his microphone. Boyle recalled that the broadcasting team knew Artest's personality and "there was no way we were going to put an open mic in front of Ron Artest in that situation". Pacers president Donnie Walsh later stated that Artest was following advice he had received on how to calm down and avoid trouble in a volatile situation.
Ninety seconds after Wallace shoved Artest, most of both teams' players and coaches were huddled at midcourt, attempting to calm down Wallace. Tayshaun Prince was the only player on either team to not leave the bench during the entire incident. Others became automatically eligible for one-game suspensions. While Artest was lying on the table, Wallace threw a towel at him, causing Artest to briefly stand up before being held back by coaches and fellow teammate Reggie Miller. A spectator, John Green, then threw a plastic cup of Diet Coke at Artest, hitting him in the chest.
Artest immediately reacted to this by jumping off the table, charging into the stands, and grabbing another spectator, Michael Ryan, whom he mistakenly believed was responsible. Artest shouted at Ryan, "Did you do it?", to which Ryan replied, "No, man. No!" Boyle stood from his chair at the broadcast table in an attempt to hold back Artest and was knocked backwards and stepped on, suffering five fractured vertebrae and a gouge on his head. Afterwards, Artest apologized to Boyle and said he had not realized he had trampled him.