New York Giants quarterback Y.A. Tittle (center) rolls out during a football game against the Cleveland Browns in 1964. (Anonymous)

Y.A. Tittle, a Hall of Fame quarterback who became a master of the long pass in 17 rugged, occasionally bloody seasons of pro football, winning nearly every honor and title save a championship, died Oct. 8 at a hospital in Stanford, Calif. He was 90.

The cause was congestive heart failure, said his son John Tittle. He had been diagnosed with dementia, ESPN magazine reported in 2014.

Mr. Tittle, who spent his childhood in East Texas targeting the bushes with high-velocity throws, achieved near-total victory in high school, at Louisiana State University and with the San Francisco 49ers and the New York Giants, whom he led to three straight title games in the early 1960s.

He set National Football League records for passing yards, touchdowns and completions and was named Most Valuable Player in 1963. In place of a championship trophy, he acquired a reputation as one of the game’s toughest players, and became a gridiron legend following a grainy 1964 photograph that Mr. Tittle referred to simply as “the blood picture.”

Taken by Morris Berman of the Pittsburgh Post-Gazette, the photo showed a 38-year-old Mr. Tittle on his knees, gazing toward the grass as blood trickled past his left eye and ear. Though open-mouthed, he later said he could not breathe.

Mr. Tittle, after throwing an interception against the Pittsburgh Steelers, in 1964. (Morris Berman/Pittsburgh Post-Gazette)

In the final minutes of a game against the Pittsburgh Steelers, Mr. Tittle had thrown a pick-six, an interception returned for a touchdown; in the process, he had been thrown to the ground by a 270-pound defensive tackle, John Baker.

The game was lost, and so — in time — was Mr. Tittle’s career. An X-ray showed that muscle had been torn from his rib cage, the latest in a string of injuries.

“It made me gun-shy,” Mr. Tittle told Smithsonian magazine in 2007. “For the first time in my life I didn’t want to get hit, because I couldn’t get up.”

He retired at the end of the season, after his wife told him it would be foolish to continue.

Mr. Tittle had by then compiled a career that would land him in the Pro Football Hall of Fame in 1971. He was the All-American Football Conference’s rookie of the year in 1948, playing for the Baltimore Colts, and in 10 seasons with the 49ers led the “Million Dollar Backfield,” one of the greatest offensive units of all time.

Featuring running backs Hugh McElhenny, Joe “The Jet” Perry and John Henry Johnson — all future Hall of Famers — the offense bulldozed opposing teams on the ground while Mr. Tittle developed an innovative pass play inspired by a highflying basketball move.

Frustrated during a practice session in 1957, “I decided to just throw the ball straight up into the air — with no receiver in mind,” Mr. Tittle said in “Nothing Comes Easy” (2009), a memoir he co-wrote with Kristine Setting Clark.

“Just then someone on the sidelines yelled out, ‘Hey, that’s our Alley-Oop play!’ ”

A last-second Alley Oop from Mr. Tittle helped San Francisco beat the Detroit Lions, 34-31, in a crucial 1957 game that helped the 49ers finish the season in a tie, with Detroit, for the league’s Western Conference title. In a rematch against the Lions that would decide who advanced to the championship game, Mr. Tittle’s team collapsed, squandering a 27-7 halftime lead.

The loss seemed to take a toll, as Mr. Tittle’s productivity diminished and he drew boos from fans at home. Before the start of the 1961 season, he was traded to the Giants, where he was expected to ride the bench behind 40-year-old Charlie Conerly, a rival from his college days.

Yet in a remarkable late-career turnaround, Mr. Tittle established himself as the dominant passer, for the Giants and for the entire league.

Known as the Bald Eagle — he went bald early and had a weathered face that made him look older than 40 — he led the Giants to conference titles in 1961, 1962 and 1963, when he held the most passing yards in the league and threw 36 touchdown passes. The touchdown mark stood as a league record until Dan Marino threw 48 in 1984.

In a 1962 victory over the Washington Redskins, he threw a record-tying seven touchdown passes. The record stands, and was tied most recently by Drew Brees, of the New Orleans Saints, in 2015.

Still, Mr. Tittle’s fortunes seemed to last only until championship day. His Giants were beaten twice by the Green Bay Packers — their 1961 game ended in a disastrous 37-0 loss for Mr. Tittle, who threw four interceptions — and narrowly lost to the Chicago Bears in 1963.

Mr. Tittle hurt his knee and threw five picks in the 14-10 loss. “Unfortunately,” he said afterward, “Lady Luck never did shine my way on championship day.”

Yelberton Abraham Tittle Jr. was born in Marshall, Tex., on Oct. 24, 1926. His father worked at the post office, and an older brother — Jack Tittle — played football at Tulane University.

Mr. Tittle was a three-sport athlete in high school but dropped basketball and baseball after receiving a scholarship to LSU.

Leading a T-formation offense in an era when quarterbacks called plays without help from coaches on the sidelines, he brought LSU to the 1947 Cotton Bowl, which ended in a 0-0 tie.

He also played on defense, leading to one of his most legendary plays. After intercepting a pass from Conerly in 1947 — then quarterback for the University of Mississippi — Mr. Tittle was nearly tackled by a player who ripped his belt, purportedly causing his pants to fall to his ankles. Thirty yards away from scoring a touchdown that would have given LSU a late lead, with his fiancee watching from the crowd, Mr. Tittle paused.

“I had to stop and hitch up my britches, or I’d have stumbled. That’s when the Rebels nailed me,” he later said, using the nickname for Ole Miss players. “Goodbye ballgame!”

Mr. Tittle married Minnette DeLoach later that year, and graduated with a bachelor’s degree in physical education.

His wife died in 2012 and was predeceased by their son Mike Tittle.

Survivors include three children, John Tittle of Pleasanton, Calif., Dianne DeLaet of Menlo Park, Calif., and Patrick Tittle of Napa, Calif.; a brother; seven grandchildren; and numerous great-grandchildren.

Mr. Tittle settled in Atherton, Calif., and ran an insurance and real estate business after retiring from football. He said a day rarely passed when he didn’t think about the game.

“Fall is still the saddest part of the year for me,” he told Smithsonian magazine, thinking back to his high school days. “It’s because the leaves are turning, and if the leaves are turning, we’re getting ready to play Longview or Tyler.”