Reigning Giro d'Italia champion Tom Dumoulin (Sunweb) took 37 seconds on last year's Tour de France and Vuelta a Espana victor Chris Froome (Team Sky) on the 9.7 kilometre individual time trial as the first Grand Tour of the season began in Jerusalem.
The Team Sky rider suffered a huge set-back to his title hopes before the race even began as he was toppled while carrying out a time trial recon.
The British lost Dumoulin 37 seconds and completed the first stage only on the 21st place.
The world time-trial champion now knows he should be able to put serious amounts of time into all his rivals for the general classification in the Giro's second time-trial, a longer, flatter effort at the start of the third week on May 22.
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The Giro d'Italia is the only Grand Tour title that has eluded Froome, who is under increased scrutiny as the UCI, cycling's world governing body, investigates his adverse analytical finding during his Vuelta a Espana triumph previous year.
His team said it was just a case of cuts and bruises but that looked like an understatement four hours later when he went through the intermediate split way down on the early leader Rohan Dennis. The 32-year-old returned an adverse finding from a urine test taken during the Vuelta a España last year which indicated twice the permitted level of the asthma drug salbutamol.
Then there will be stages in "the Haifa - tel Aviv and be'er Sheva - Eilat".