The ruling Friday by the NBA leaves the Grizzlies without their leading scorer for the deciding game in Oklahoma City on Saturday night.
The play came with 6:42 left in the Thunder's 104-84 victory Thursday night. Randolph first elbowed Adams in the midsection with his left elbow, then struck Adams with his right hand.
Randolph is averaging a team-best 18.2 points in the series.
Memphis coach Dave Joerger's team has dealt with injuries and lineup changes all season. Tony Allen missed 27 games this season, Marc Gasol 23 and Mike Conley nine. Kosta Koufos and Ed Davis will likely fill Randolph's minutes.
"This is it," Joerger said. "Whatever you want to say about the season, it's all come down to one game. Certainly, for us to have the best chance to win, we have to play better than we did last night."
Information from The Associated Press was used in this report.
Randolph Suspended For Game 7
ESPN analyst Bruce Bowen breaks down the NBA suspending Grizzlies forward Zach Randolph for Game 7 for punching Thunder center Steven Adams in Game 6.