Spain's El Celler de Can Roca - which took the third spot previous year - won second this time around, while France's Mirazur climbed from fourth to third.
All winners were published and tagged on The World's 50 Best's Twitter page.
Spain continued to dominate the line-up with three restaurants in the top 10, including El Celler de Can Roca, while France had two including Mirazur.
The World's 50 Best Restaurants list is one of the most influential and prestigious culinary rankings around. The restaurant, farm, and inn in Healdsburg, Calif.is run by married couple Katina and Kyle Connaughton.
Owner Luke Dale-Roberts says he's ecstatic about the award.
Tuesday's ceremony also handed out individual chef awards.
Massimo Bottura accepted the award for the three-Michelin-star restaurant in Modena, Italy, saying, "This is wonderful". At No. 18, Disfrutar of Barcelona received the Highest New Entry Award for 2018.
Peru's celebrity chef Gaston Acurio, who is known for combining classic European techniques with typical ingredients from the Andean country, was given a lifetime achievement award.
"For the last 10 years of my career, I've been asked, 'What is it like to be a female chef?' To which I reply: I'm not sure what you mean, because I've never been a male chef", said Smyth, who is chef at London's Core, which was mistifyingly absent from the main list.
The Woodstock-based eatery is among the best restaurants on the globe. This year, there were only five women chefs (and co-chefs) who had restaurants represented on the list: Pia León (at Central with Virgilio Martínez), Elena Arzak (at Arzak with Juan Mari Arzak), Ana Ros (at Hiša Franko), Daniela Soto-Innes (at Cosme with Enrique Olvera), and Pim Techamuanvivit (at Nahm.) Three of those women have male co-chefs.
In 2017, the list included no restaurants in Africa, the Middle East and India.