Osteria Francescana was crowned number one in 2016 and came second last year before rising back to take the top spot in 2018.
"I am going to use this spotlight to make even stronger the changes there are going to be," said Bottura at a press conference following his win. "Feed the planet. Fight waste. Last week Henry Kissinger asked me for a selfie. It is unbelievable. We have to involve all the community of chefs … pushing the spotlight you have to make the invisible visible is extremely important."