Former New York City Mayor Rudy Giuliani was spotted at a baseball game in New Hampshire with his once-rumored girlfriend — just hours before he was badly injured in a freak car accident.

The 81-year-old could be seen sitting next to Maria Ryan, a nurse-practitioner, as they took in the Fisher Cats minor league game in Manchester on Saturday night.

Footage shot by local TV station WMUR captured the pair watching something on Ryan’s phone as the game played out.

It wasn’t immediately clear if Ryan was in the car with Giuliani when another vehicle plowed into the back of his rented SUV on a highway hours later.

Giuliani suffered fractured vertebrae and multiple cuts and bruises to his left arm and lower leg in the wreck.

When he was discharged from the hospital Monday afternoon, Ryan told The Post she was helping to oversee his care.

Giuliani and Ryan have for years been dogged by rumors they are an item.

After the local news clip emerged, Giuliani’s spokesman Michael Ragusa stressed the duo’s relationship was strictly professional and that she oversees his health care.

“Recent speculation regarding the nature of the relationship between Mayor Rudy Giuliani and Dr. Maria Ryan is categorically false. The Mayor and Dr Ryan share nothing beyond a professional relationship,” Ragusa said in a statement.

“Any suggestion to the contrary is both unfounded and misleading. Mayor Giuliani and D. Ryan remain committed to transparency and professionalism. At this time, their sole focus is on the Mayor’s continued recovery and his return to work serving the American people.”

“Dr Ryan, a highly respected medical professional with decades of experience in the healthcare field, has overseen all aspects of Mayor Giuliani’s medical care,” he continued.

“Her role is strictly focused on ensuring the Mayor’s health and recovery, drawing on her extensive background in clinical leadership and patient care.”

He added, too, that other business associates had joined Giuliani at the baseball game.

Meanwhile, the former mayor’s driver, Ted Goodman, was also injured in the crash when their vehicle was struck from behind by a Honda HR-V driven by a 19-year-old woman late Saturday, cops said.

Just prior to the accident, Giuliani had been “flagged down by a woman who was the victim of a domestic violence incident” and had contacted cops on her behalf, Ragusa said.

Giuliani then continued on his way but his vehicle was hit shortly after pulling onto the highway in an unrelated crash.

Ragusa said on X that “no one knew it was [Giuliani]” in the rental.

Giuliani’s release from the hospital comes after President Trump revealed he’ll be awarding him the Presidential Medal of Freedom — the nation’s highest civilian honor.

Trump in a statement on social media called Giuliani the “greatest Mayor in the history of New York City, and an equally great American Patriot.”