Taking out the top gong after its first win in 2016, Massimo Bottura’s Modenese restaurant is known for sourcing ingredients from the surrounding Emilia-Romagna region and celebrating classic Italian dishes from an artistic, philosophical and cultural perspective.

In its early days, the restaurant almost closed after conservative locals were resistant to Bottura’s innovative approach to Italian cuisine.

Thankfully, the locally born chef and his American wife Lara Gilmore persisted.

Bottura and Gilmore accepted the award on behalf of their staff.

“This is something we all built together,” Bottura said.

“I'm not going to disappoint you. I’m going to use these spotlights for all of us to show the world that chefs in 2018 are much more than the sum of their recipes. We can have a very loud voice of change if we stay together.”

Gilmore echoed Bottura’s sentiment.

“We have the possibility to change the future,” she said.

“And that's the greatest mission we can accomplish.”

In second place was El Celler de Can Roca while Mirazur on the French Riviera rounded out the top three.

Last year’s number one Eleven Madison Park fell to fourth place.

Three other Italian restaurants made the list: Piazza Duomo in Alba, Piedmont (no. 16), Le Calandre in Rubano, Veneto (no. 23) and Reale in Castel Di Sangro, Abruzzo (no. 36).

Melbourne restaurant Attica, which placed at number 32 last year, continued its rise up the ranks to 20th place – its highest ranking so far – and was awarded Best Restaurant in Australasia.

The Sustainable Restaurant Award went to Azurmendi, a Basque restaurant that recycles its own waste and uses solar panels and recycled rainwater to reduce its energy needs.

New York chef Dan Barber was nominated by his peers for the Chef's Choice Award while Geranium of Copenhagen took out the Art of Hospitality Award.

This year's award for Best Female Chef, announced in April, went to Clare Smyth, who opened her first restaurant, Core by Clare Smyth, in London last year after more than 15 years working in Michelin-starred kitchens including alongside Gordon Ramsay.

Peruvian chef Gastón Acurio won the Lifetime Achievement Award for raising the profile of Peru’s cuisine by opening a chain of restaurants around the world over the last 20 or so years.

The One to Watch Award was handed to SingleThread, a Northern Californian restaurant and inn that draws heavily on Japanese traditions and was opened by couple Katina and Kyle Connaughton in late 2016.

The World’s 50 Best Restaurants 2018:

1. Osteria Francescana, Modena, Italy

2. El Celler de Can Roca, Girona, Spain

3. Mirazur, Menton, France

4. Eleven Madison Park, New York, USA

5. Gaggan, Bangkok, Thailand

6. Central, Lima, Peru

7. Maido, Lima, Peru

8. Arpège, Paris, France

9. Mugaritz, San Sebastián, Spain

10. Asador Etxebarri, Axpe, Spain

11. Quintonil, Mexico City, Mexico

12. Blue Hill at Stone Barns, Pocatino Hills, New York, USA

13. Pujol, Mexico City, Mexico

14. Steirereck, Vienna, Austria

15. White Rabbit, Moscow, Russia

16. Piazza Duomo, Alba, Italy

17. Den, Tokyo, Japan

18. Disfrutar, Barcelona, Spain

19. Geranium, Copenhagen, Denmark

20. Attica, Melbourne, Australia

21. Alain Ducasse au Plaza Athénée, Paris, France

22. Narisawa, Tokyo, Japan

23. Le Calandre, Rubano, Italy

24. Ultraviolet by Paul Pairet, Shanghai, China

25. Cosme, New York, USA

26. Le Bernardin, New York, USA

27. Boragó, Santiago, Chile

28. Odette, Singapore

29. Alléno Paris au Pavillon Ledoyen, Paris, France

30. D.O.M., São Paulo, Brazil

31. Arzak, San Sebastián, Spain

32. Tickets, Barcelona, Spain

33. The Clove Club, London, UK

34. Alinea, Chicago, USA

35. Maaemo, Oslo, Norway

36. Reale, Castel Di Sangro, Italy

37. Restaurant Tim Raue, Berlin, Germany

38. Lyle's, London, UK

39. Astrid y Gastón, Lima, Peru

40. Septime, Paris, France

41. Nihonryori RyuGin, Tokyo, Japan

42. The Ledbury, London, UK

43. Azurmendi, Larrabetzu, Spain

44. Mikla, Istanbul, Turkey

45. Dinner by Heston Blumenthal, London, UK

46. Saison, San Francisco, USA

47. Schloss Schauenstein, Fürstenau, Switzerland

48. Hiša Franko, Kobarid, Slovenia

49. Nahm, Bangkok, Thailand

50. The Test Kitchen, Cape Town, South Africa