Metta World Peace will likely miss the first round of the NBA playoffs after league officials handed him a seven game suspension. During a game on April 22, World Peace threw an elbow to the head of Oklahoma City’s James Harden. Harden was left with a concussion and has yet to be cleared to return to play.

Before throwing the violent elbow, World Peace had taken great measures to clean up his image. In 2011, he won the coveted J. Walter Kennedy Citizenship Award. However, World Peace will always remembered for attacking Pistons’ fans during a game in 2004. He was suspended 86 games that year.

But World Peace’s elbow to Harden’s head isn’t an anomaly. Here are the five most vicious altercations in the NBA.

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