The singer, wearing knee high stilletto boots, was standing atop a piano with one foot on a stool vigorously strumming an air guitar when she slipped.
Despite ending up on her back on the floor, Gaga, continued performing her song You And I to a packed concert hall in Houston, Texas.
A video of the incident was captured by fan Eric Souknary, 18.
"It was in the middle of the show. She was really high up and it looked really bad," he said.
"I only just managed to keep the video steady. The crowd all saw it and I don't think anyone would have minded is she'd walked off the stage to get checked out by medics.
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