At present, Trey Smith is regarded as one of the cornerstones of the Kansas City Chiefs’ offensive line, the highest-paid guard in the NFL, and a two-time Super Bowl champion. But his NFL journey almost never took off. During his sophomore year at Tennessee, Smith was diagnosed with blood clots in his lungs, and in a recent appearance on “In Good Company with Mitch Morse,” he revisited that difficult chapter.

“I can’t stand up, I can’t catch my breath, I’m like, ‘I’m not that out of shape. What’s going on? I was running fine last week,'” Smith said, recalling his diagnosis. “And I remember going to the doctor, like, ‘Hey doc, I’ve lost 13 pounds in a day. I feel horrible. I can’t breathe. I’m struggling for everything.'”

At that point, Smith had already made a strong impression at Tennessee. He started all 12 games as a freshman and followed it by starting the first seven games of his sophomore season. Ahead of Smith’s sophomore year, the Volunteers brought in a new head coach, Jeremy Pruitt, from Alabama.

With a new staff in place, the focus shifted to identifying core pieces for the future. Given Smith’s freshman year, he was clearly one of those players. The staff saw him as someone they could build around. The problem, however, was that something was already going wrong behind the scenes.

As practices intensified, Smith continued to push through. He embraced the workload. But then things changed quickly. One day, he passed out. He struggled to breathe and dropped 13 pounds in a single day.

Initially, doctors believed it might be a respiratory issue. But the concern grew when even basic movement became difficult. Smith recalled walking to the library to his English teacher and having to stop multiple times just to catch his breath. Once while heading to the library and thrice while on his way back.

“I went to class later on that day, and I had to stop like five times just to catch my breath,” he said. Just to go to the library to write a paper, which is like 500 yards away, I had to sit down and physically stop.”

That was the turning point. Soon after, the 26-year-old received a call from team physician Dr. Chris Klenck, and the situation became serious.

“And I remember getting that call, and the team doctor’s like, ‘Hey man, wherever you’re at, stay right there. We’re going to rush you to the hospital. Just don’t worry.’ I remember getting to UT Medical, they hooked me up to machines, shots in my body, and I remember just lying in the hospital bed…The doctors opened the door, and I was never able to look on his face. It’s just like so serious. He’s like, ‘Hey son, let you know we found blood clots in both sides of your lungs.”

The diagnosis came on February 17, just before spring practice. Tennessee ruled him out of his sophomore season indefinitely. But for Smith, it was not just about football. It was personal. He had lost his mother just a couple of years earlier after watching her spend her final months in a hospital bed, which made the moment even heavier.

Still, there was a way forward.

After months of treatment, Smith recovered. He went through extended rounds of anticoagulants and worked closely with doctors and specialists to determine the safest path back. Eventually, he returned for his junior season. Despite speculation about entering the 2020 NFL Draft, he chose to stay for his senior year and declared in 2021.

When draft weekend arrived, the Chiefs selected him in the sixth round with the 226th overall pick.

Now, looking at where he stands today, a two-time Super Bowl champion and the highest-paid guard in the league, that journey hits differently. It is not just about success. It is about everything he had to overcome just to get there. And now, he’s heading into his sixth season with the Chiefs. And ahead of that, he’s optimistic for the 2026 season.

Trey Smith addressed criticism after the Chiefs’ down year

Trey Smith had not really experienced a down season since arriving in the NFL, at least not until 2025. The same could be said for the Chiefs as a whole. For years, they had set the standard. That changed in 2025, and like many others on the roster, Smith found himself in unfamiliar territory.

Kansas City missed the playoffs for the first time in years. With that came the usual noise, questions about whether the run was over and whether the window had finally closed. Smith, however, did not buy into that narrative. Speaking with Kay Adams on the Up & Adams show, he leaned on a Mike Tomlin mindset and pointed toward accountability.

“I think back to the Mike Tomlin quote,” he said. “We do not care. We don’t care at the end of the day. We’re gonna play ball. We’re just doing our job. All of last season, we weren’t playing our best ball. We weren’t playing complimentary football.

“At the end of the day, we have to just go back to the drawing board and be great this offseason. Everyone has to prepare. Individually, I have to look myself in the mirror and look at how I’m doing to be better for our team. It’s a chip on the shoulder mentality at the end of the day. Just so I can be the best version of myself for this organization.”

That response reflects where the Chiefs are right now. This offseason feels different. There is more urgency, more self-evaluation, and a clear understanding that last year was not up to their standard.

Because of that, a level of roster reshaping was expected, and to some extent, it has already happened. The Chiefs have addressed multiple needs, trying to reset without completely tearing things down.

Now the focus shifts to what comes next. The question is not just about roster moves anymore. It is about whether Kansas City can respond on the field and push back against the idea that their run is over.