Van der Breggen went into the women's world championships time trial with four silver medals from previous efforts against, but without the coveted rainbow jersey in the solo discipline.
"Finally," van der Breggen said after conquering the world time trial title around the flat 31.7-kilometre course in Imola, Italy. "This is very good, I think it's really cool."
"After having finished second for so many years ... I still can't believe it. I didn't want to know anything along the way. It was not the ideal course for me, but I just wanted to ride as fast as possible. Then I cross the line and I hear that I am world champion... that's super nice."
Van der Breggen said that she thought that she had made some mistakes with her pacing in the race, passing the intermediate time check nine seconds behind eventual second-placed finisher Marlen Reusser (Switzerland).
"At first I have an unsatisfactory feeling," said van der Breggen. "When I crossed the finish line, I thought: I really left it on the way there, I really started too slow. On the way back I thought: just go ramming!"
Defending champion and pre-race favourite Chloe Dygert (USA) was on track to secure her second consecutive world title in the event but appeared to suffer a sudden puncture while cornering at speed. She crashed over a guard rail and down a steep embankment. She was treated by medical staff before being transferred by ambulance to the hospital in Imola.
At the midway checkpoint, Dygert was ahead of Reusser by 26.54 seconds, but the crash put paid to her securing a second successive rainbow jersey.
Grace Brown was Australia's only participant and managed a strong performance, ending her 31.7-kilometre effort as the fastest finisher and sitting in the hot seat until she eventually finished fifth overall, a minute and one second behind van der Breggen.
The USA came in as the favourites, and fielded three riders in the time trial. Stephens and Neben started earlier, then defending champion Dygert was the last to roll off the starting ramp kitted in the Team USA skinsuit and tall pink socks and shoe covers, and racing on a team-issued Felt DA time trial bike.
Dygert pushed an enormous gear over the flat roads and smashed through the intermediate time check at an astonishing 19:35, nearly half a minute faster than Reusser. However, just as she appeared to be headed for her second world title, Dygert crashed through a righthand bend on a downhill and went over the roadside barriers, with video footage showing her going over the barriers and her bike and onto the other side into a grassy ravine, and was not able to complete the event.
Ellen van Dijk (Netherlands) made the most of her opportunity as a late call-up for injured star Annemiek van Vleuten, finishing third, 31 seconds behind van der Breggen.
The World Championships continues tonight with the men's time trial from Imola, Italy. Rohan Dennis and Luke Durbridge will fly the flag for Australia, with coverage beginning from 2225 AEST on SBS On Demand and streaming via the Cycling Central website.