The Portuguese was being towed back out by jet-ski driver Hugo Vau when both were flung into the air in a collision between two huge waves at the notorious Atlantic coast spot.

The surfers and their jet-ski were engulfed by a wall of breaking whitewater and tossed violently towards the shore before rescuers were able to retrieve Botelho, who appeared to be unconscious and was floating face down in the sea.

He was placed on a backboard and rushed to hospital as shocked onlookers and surfing fans around the world watched what the World Surf League (WSL) deemed a “very serious incident.”

“Currently, he is stable and conscious. He will stay at the hospital for further evaluation,” said a statement for WSL, the organizer of the Nazaré Tow Surfing Challenge.

The WSL, which runs the professional surfing circuit, added: “A heartfelt thank you to the safety and medical teams for their quick response. We are wishing Alex a full and speedy recovery.”

CNN has contacted the WSL and is awaiting an update on Botelho as well as comment on safety procedures.

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Portuguese surfer Hugo Vau rides a wave during the Nazare Tow Surfing Challenge.
Nazaré is a notorious hunting ground for big wave surfers with storms out in the Atlantic creating huge breakers.
Big wave surfers wrestle with death to feed addiction thrill
In 2017, Brazilian surfer Rodrigo Koxa broke the world record for the biggest wave surfed, after riding a wave measuring 80 feet (24.38 meters) tall.
Koxa’s record beat the previous mark of 78 feet (23.77 meters) surfed in 2011 by Hawaiian Garrett McNamara, also in Nazaré.

The incident with Botelho has renewed calls for the WSL to consider removing big wave locations like Nazaré from the league’s calendar.

Carve Surfing Magazine posted on Twitter: “we have to ask when is enough enough and we have to watch someone die live on TV before [World Surfing League] draws a few lines in the sand.”

Fellow surfer Nic von Rupp took to Instagram to voice his thoughts, saying: “Today I was confronted with the reality of our sport, heartbreaking watching my brother [Alex Botelho] between life and death right in front of the eyes of the world.

“Honestly, very few would have survived, just a beast of a human like Alex to pull thru.. not only because the strong human he is, but mostly for the love many people have for him praying to pull thru.

“Love you brother, to many more sessions!!! Best recovery to you guys @hugovau @alex_botelho.”