Indiana's Ron Artest fouled Detroit's Ben Wallace when he went in for a layup with 45.9 seconds left and the Pacers leading 97-82.
Wallace wheeled around and delivered a hard, two-handed shove to Artest's chin, which led to pushing and shoving with several players near midcourt.
Artest lay on the scorer's table with his hands behind his head. Wallace tried to get at Artest but was held back by teammates and coaches.
As players shouted at each other, Wallace threw a wristband toward Artest, who stood up briefly before lying back down on the table.
An unidentified fan near midcourt hit Artest with a cup filled with ice and a beverage.
Artest stormed into the stands and attacked a fan he thought hurled the cup at him.
Indiana's Stephen Jackson joined his teammate in the seats and started throwing punches. Some fans also punched the players.
David Harrison, Eddie Gill and Fred Jones of the Pacers, Detroit's Rasheed Wallace and former Piston Rick Mahorn tried to break up the fight.
Back on the court near Indiana's bench, Artest punched a fan wearing a Pistons jersey who walked toward him. After another fan tried to tackle Artest and was trying to stand up, Jermaine O'Neal ran toward him and punched him in the face.
Pacers players and coaches left the floor and were pelted with beer, popcorn, a folding chair and other items.
Indiana's Jamaal Tinsley tried to go back on the court, holding a metal dustpan over his head before being turned back to the locker room.
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