Simone Biles has missed out on a fourth gold medal of the Paris Olympics after falling during her balance beam routine.

The US gymnastics sensation fell off the beam midway through her routine in the women’s balance beam final – which was won by Italian Alice D’Amato.

Biles, 27, had already secured golds in the team all-around, individual all-round, and vault events, and was hot favourite to secure her fourth of the games.

However, her fall from the beam meant she missed out on the medal she has long coveted, finishing fifth.

There was a loud “ohhh” from the thousands of fans inside a packed Bercy Arena in the French capital as she lost her balance and had to hop off the beam and onto the mat around half-way through her routine.

She is scheduled to compete in the floor exercise later on Monday, an event where she’s never lost a major international competition, and took gold in Rio de Janeiro eight years ago.

Biles, the most decorated gymnast in history, won her seventh gold medal, and third of the Paris games, on Saturday with victory in the women’s gymnastic vault event.

This summer’s competition has been a triumphant return to the Olympics for Biles, who was one of the biggest stories of Tokyo three years ago when, as the favourite to win multiple golds, she pulled out of most of her events.

She later revealed she was suffering from “the twisties”, where a gymnast loses sense of where they are in the air.

She faced high-profile criticism following her decision to drop out and has since been working with a therapist in Paris.

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