SCOTTSDALE, Ariz. -- Sound the alarm, Andrew Painter is back on the hill.

As Philadelphia’s top-ranked pitching prospect took a deep breath and threw his warmup tosses ahead of his first game action since March 2023, an ambulance siren blared outside of Scottsdale Stadium -- a moment of levity amid an arduous path back to the mound.

Painter’s first step in his return from July 2023 Tommy John surgery came Saturday afternoon during Arizona Fall League play, as he took the mound with “Phillies” emblazoned across his chest. The right-hander pumped his fastball as hard as 99-100 mph during his first inning of action, which included getting rehabbing Mets infielder/outfielder Jeff McNeil to fly out and Giants top-ranked prospect Bryce Eldridge to strike out on a breaking ball.

The second inning proved more laborious for Painter: He allowed a leadoff solo homer to Tigers No. 9 prospect Josue Briceño, going on to yield an RBI later in the frame as well. In total, MLB’s No. 32 prospect threw 29 pitches (18 for strikes) and allowed two runs on three hits and one walk with a pair of strikeouts.

“I thought obviously the results weren't exactly what I wanted, but arm's healthy and that was the biggest takeaway,” Painter said. “Everything felt like it was coming out good, like my old self.”

Painter’s old self was one of the most dominant Minor League pitching prospects to come from the high school ranks in the past decade. In 109 2/3 frames across four levels, Painter struck out 167, posted a 1.48 ERA and saw batters produce a combined .507 OPS. His 70-grade heater was so dominant at the lower levels that he climbed as high as Double-A Reading as a 19-year-old.

To start 2023, Painter was MLB Pipeline’s No.1-ranked pitching prospect in all of baseball (No. 6 overall). But after just two innings of a Grapefruit League outing on March 1, 2023, he was shut down. He attempted to rehab his elbow with non-surgical measures, but by the summer, he knew it was the necessary course of action in the long term.

“More of a new chapter,” Painter said of his altered mindset. “It's a new elbow, so I'm a new person now. You can look at that stuff and think back, but I think it's just a dangerous spot to be in.”

Still just 21 years old, Painter’s gone through the gamut not just physically by having the game taken away, but mentally as well. He lauded the work done at the club’s complex alongside Dr. Traci Statler, the Phillies’ mental performance scouting and rehab coordinator.

“Baseball's been my thing growing up and it's been something I've loved,” Painter said. “Getting that taken away from me, I think it just made me appreciate the game so much more. I just really look forward to any time I get to be out here on the field and just go to the field every day.”

Painter is expected to throw around 20 innings over the coming weeks for the Glendale Desert Dogs, priming him for a chance to compete for a big league rotation spot come 2025. Despite not having consistently pitched since late 2022, when he has tossed just 28 1/3 innings at the Double-A level, the 6-foot-7 hurler is firmly on the Phillies’ radar.

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“I do think he’ll be pitching at the big league level at some point in ‘25,” Phillies president of baseball operations Dave Dombrowski said earlier this week. “He’s not going to be able to go out there like a big league starter and pitch every five or six days and pitch a whole season and have 180 innings. He’s going to be limited, much more than that.

“So how do we do that? Do we start pitching him in games later? Do we start pitching him at the Minor Leagues once a week and limit the innings? Could he pitch here? Yes, but it also depends how he does.”

“I think it was always a possibility,” Painter said of pitching in the Fall League, “but I know some of the main focus was the rehab process. It's a long process. So I think that the thought process there was kind of just be where your feet are at and live in the present and not put those goals in front until that time comes.

“End goal is always pitching in the big leagues, and pitching in the big leagues for a while.”