The Hammers skipper took a right hook from Stoke slugger Robert Huth and finished yet another defeat bloodied, bruised and battered.
And that was just his pride, never mind the damage Huth inflicted.
But stitches in a cut near his right eye could not blind Upson to his part in this sorry set-back that left the visitors still in the bottom two.
Upson was at fault for the second of James Beattie's two goals before being laid out by Huth's haymaker.
Those incidents overshadowed his earlier header that had cancelled out Beattie's spot-kick opener.
But it was symbolic of the Hammers' current plight to see Upson crashed out on the canvas as Gianfranco Zola's men endured another KO.
Huth's heavyweight blow was delivered away from referee Martin Atkinson's view as players jostled for a better position at a free-kick.
But it was caught on camera and Huth's roundhouse punch is sure to draw an in-house fine as Stoke try to pre-empt an inevitable FA charge.
Those same cameras will probably shame Hammers old boy Matt Etherington as well for his part in winning the soft early penalty.
Julien Faubert tried his hardest to pull out of the tackle but was left aghast as the ref pointed to the spot and Beattie made no mistake.
That was the opening salvo in a defeat for a visiting side devoid of invention and the old East End 'too good to go down' optimism is looking misguided once again.
Zola could have been forgiven for eyeing the chance to abandon ship this week when an approach from Napoli was mooted.
He remained loyal but even he will find it difficult to steer this rudderless vessel away from the rocks.
No cash, no class and no cutting edge. The football the Hammers are so proud of has no currency in the battle to earn points at the bottom.
When you're this deep in the mire it's time to put on your wellies. This troupe turned up in dancing shoes.
In a game where workhorses were needed all West Ham mustered was a show pony in Alessandro Diamanti.
The Italian's a fake, more concerned with hitting the ground than the target and he was their best player!
It needed a slip from Stoke keeper Thomas Sorensen to give the Londoners an equaliser on 34 minutes.
Upson, black-eyed and blood-splattered from an earlier accidental kick off Ryan Shawcross, charged in to head in a corner as the Potters No 1 flapped.
But Stoke rolled up their sleeves and Beattie, binned long ago by England, showed current Three Lion Carlton Cole how it is done.
His desire was never more evident than when he outfought Faubert before toeing in the rebound from Ricardo Fuller's shot for the winner.
Before that Fuller had danced around Upson on the way to goal.
By contrast Cole was snuffed out by Shawcross, the ex-Manchester United defender, who blocked the only chance that came Cole's way.
That ensured Stoke's first win in three at home. With him at the heart of their defence, it won't be their last.
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