Moments before Otis' surprising win, King Corbin hurled ring great Rey Mysterio and up and comer star Aleister Black off the roof of WWE's headquarters.
WWE fans are used to seeing insane stunts, but two superstars falling from the Titan Towers in Stamford, Connecticut was something else and there has been no word on their condition since.
For the first time, the ladder match to determine who captured the briefcase containing a contract offering a guaranteed world title shot didn't begin in an arena.
Instead the six male contenders fought it out in a gym on the ground floor, while the six women lined up in the lobby, where Japanese star Asuka leapt off a balcony to take them out, then caught a lift.
On the way to the roof there were plenty of surprise cameos from WWE's past and present, including Doink the Clown, Brother Love, Stephanie McMahon and John Laurinaitis, along with Paul Heyman, who became embroiled in a huge food fight.
Meanwhile, AJ Styles and Daniel Bryan - a dream match for fans for many years - ended up brawling in the worst place possible: Vince McMahon's office!
The WWE Chairman blasted the pair and ordered them both outside, as viewers marvelled at the Tyrannosaurus Rex the billionaire has hanging on the wall.
At the climax of the men's match, AJ Styles and King Corbin fought over the briefcase, when Elias suddenly arrived and hit Corbin with his trademark guitar.
That left Styles holding onto the briefcase, but only for a second as he fumbled it and watched on as it agonisingly fell into the grateful arms of Otis.
The underdog - one half of the tag team Heavy Machinery who won back his girlfriend Mandy Rose at WrestleMania - cemented his role as a fan favourite.
Moments beforehand, high flying legend Mysterio and former NXT Champion Black were thrown from the roof by Corbin, in a staggering sequence.
Meanwhile, Asuka triumphed by outwitting the powerhouse Nia Jax and rising talent Lacey Evans, earning the former Royal Rumble winner a huge opportunity.
That followed a stunning win by Scottish WWE Champion Drew McIntyre over Seth Rollins, in the match of the night, and Braun Strowman getting revenge over his former mentor Bray Wyatt by retaining the Universal title.
1. Jeff Hardy defeated Cesaro in a singles match
2. The New Day (c) defeated The Forgotten Sons, John Morrison and The Miz, and Lucha House Party in a Fatal 4-Way Tag team match for the WWE SmackDown Tag Team Championship
3. Bobby Lashley defeated R-Truth in a singles match
4. Bayley (c) (with Sasha Banks) defeated Tamina in a singles match for the WWE SmackDown Women's Championship
5. Braun Strowman (c) defeated Bray Wyatt in a singles match for the WWE Universal Championship
6. Drew McIntyre (c) defeated Seth Rollins in a singles match for the WWE Championship
7. Asuka defeated Carmella, Dana Brooke, Lacey Evans, Nia Jax, and Shayna Baszler in a Money in the Bank ladder match for a women's championship match contract
8. Otis defeated AJ Styles, Aleister Black, Daniel Bryan, King Corbin, and Rey Mysterio in a Money in the Bank ladder match for a world championship match contract
Watch WWE Money in the Bank live on the WWE Network or on BT Sport Box Office.
You can relive all the action as it happens in the Mirror Sport WWE Money in the Bank live blog.