The Kentucky senator's lengthy absence from the Senate generated a flood of criticism and online speculation, as he initially remained quiet for weeks about his condition.
The 84-year-old senator eventually disclosed a month later that he had been "briefly unconscious" due to the fall and had also been treated for mild pneumonia in the hospital.
He briefly addressed reporters on Monday from a wheelchair outside the Senate chamber, smiling but speaking slowly and with some difficulty. McConnell joked that he wasn't sure how many reporters would be there after dodging so many questions during his almost two decades as leader.
He said he was back in the Senate to work on a pending farm bill and because he has an ongoing interest in NATO and "backing up our good friends who are totally in the fight against the Russians".
Reporters and photographers were told by Senate staff not to take video of his remarks in the second-floor hallway, even though video is often permitted in that area. Still images were allowed.
McConnell, who holds the distinction of being the longest-serving Senate leader, is in his final months of his four decades in office. He is retiring at the end of January after one of the most consequential careers in modern politics.
In a statement issued before his remarks, McConnell made clear that he may still miss some votes due to his health issues.
He said that he is "still not quite back to 100 per cent, but I've assured Leader (John) Thune that, as I continue with physical therapy on the advice of my doctors, I will do my best to be present for tough votes when our Conference needs me."
The senator's extended leave highlighted increasing public concern about the age of lawmakers and their capacity to carry out their duties.
Toward the end of his time as leader and in the last two years as a rank and file senator, McConnell's health has visibly declined.
He was hospitalised with a concussion in March 2023 and missed several weeks of work after falling in a Washington hotel.
He twice froze up during news conferences after he returned, staring vacantly ahead.
A year later, he fell and sprained his wrist while walking out of a GOP luncheon.
