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Nadal is looking for a record-extending 13th title at Roland Garros and a 20th major overall to equal Roger Federer’s men’s record.
Nadal did not face a breakpoint in the first two sets but trailed 15-40 at the start of the third. He saved one but was broken when he hit wide down the line.
Gerasimov had a medical timeout for several minutes at 2-2. He received treatment on his right foot after an awkward fall. The foot was heavily strapped and his movement appeared limited afterwards.
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The second-seeded Nadal next faces American Mackenzie McDonald.