The race had all the makings of an epic duel as El Bakkali waited in the middle of the pack before making his move with about 300m to go, chasing down Girma who was flying through the field.
Events took a jarring turn, however, when Girma fell, drawing gasps from the crowd.
El Bakkali chased down Rooks over the final bend but the American dug deep to produce a personal best time and claim a surprise silver.
The Moroccan held his arms out wide as he crossed the finish to become the first back-to-back winner of the event since Finland’s Volmari Iso-Hollo in 1932 and 1936, while medical staff were still tending to Girma.
The fans at the Stade de France offered a smattering of applause as he was strapped to a stretcher and carried out through a tunnel.
“I actually didn’t know how bad the fall was – I didn’t know who fell until after the race – so I’ll just keep him in my prayers,” said Rooks.