Held as part of a lavish event in the Spanish port city of Bilbao, one of the world’s culinary hotspots, the occasion saw culinary masterminds from five continents gathered together.
The main prize went to Italy's Osteria Francescana and head chef Massimo Bottura, whose sometimes surreal reworkings of classic Italian recipes saw him return to the top spot he first held in 2016.
There were few other surprises in the top three, with last year's third placers and 2015 winner El Celler de Can Roca, taking second place and France's Mirazur - fourth last year - take third.
Eleven Madison Park - the 2017 winner which spent part of the year closed for renovations - was bumped down to fourth.
While European eateries continued to dominate the awards, all five continents were represented, with Bangkok's Gaggan at five on the list and Lima's Central at six.
Other significant prizes included the Lifetime Achievement Award, which went to Peruvian chef Gastón Acurio of Astrid y Gaston. France's Cédric Grolet won Best Pastry Chef and Spain's Azurmendi took a prize for sustainability.
According to organisers, the results were compiled from an independent voting panel of 1,000 judges that were subject to adjudication.