The world time-trial champion went into the race as the defending champion and favourite for the title, but had to overcome an early setback after a below-par team time trial where the squad conceded 53 seconds in their fourth-placed finish behind Canyon SRAM racing.
The queen stage summit finish up the Passo Gavia moved due to landslides and bad weather, with a comparatively moderate climb to Lago di Cancano replacing high altitude of the Gavia. That news was ill-tidings for van Vleuten, with time to make up and less climbing to help her force the issue.
Attacking with nine kilometres left to arrive at the finish of Lago di Cancano, van Vleuten flew away from the bunch with an amazing attack. She kept on pouring on the pressure as the climb continued, eventually taking
Such was the ferocity of the surge, that it prompted controversy in the race, with competitor Elisa Longo Borghini labeling van Vleuten 'an alien', what many considered a veiled doping accusation.
Mitchelton-Scott brushed aside the controversy, with van Vleuten continuing her superb form with another dominant win, this time in the time-trial on Stage 6, driving her advantage to four minutes on the general classification over closest competitor Kasia Niewiadoma.
"It's so cool to win again," said van Vleuten. "Especially as I felt even a little bit better than last year. I felt so relaxed today with all of the team around me so it was a fantastic Giro-Rosa.
"It is a dream come true again. Last year was the first time and now we did it again. It was a really big goal of mine this year and to finish it off for the second time in a row is really special."
The rest of the Australian Mitchelton-Scott squad had an eventful Giro Rosa in their own right. Grace Brown overcome being physically ill during the opening stage team time trial to finish as Mitchelton-Scott's required fourth finisher. Lucy Kennedy nearly claimed a breakthrough win with a late attack, but fell agonisingly short, passed by Marianne Vos a few metres short of the line.
Amanda Spratt has two major goals each season, the Ardennes classics and the Giro Rosa, and not only supported van Vleuten to the top step of the podium, but joined her team-mate on it with a superb ride for 3rd overall.
Spratt had been acting as a foil for van Vleuten in the mountains but was able to make the most of the final climbing stage to overtake Kasia Niewiadoma and Lucinda Brand to equal her third place finish a season prior.
Van Vleuten paid tribute to her team and their contributions after the race.
"We prepared 100 per cent, we worked so hard for this and it's so nice that it pays off with the win," said Van Vleuten. "It’s also so nice for my team. We worked hard for it, we were all prepared, we reconned stages, the whole team was all in. You feel some pressure but then it is even more special to finish it off.
"In a one-day race you can maybe win by yourself but in a stage race you really need the team everyday and that makes it so special and beautiful. We really nailed it as one team and tonight we will celebrate well."
Vos (CCC-Liv) claimed four wins in her best Giro Rosa return for some time, while Anna van der Breggen (Boels-Dolmans) was the best of the rest behind van Vleuten, claiming one particularly dramatic victory where she overcame van Vleuten in the final metres to exact some measure of revenge for the reverse happening in La Course by Le Tour de France last year.