Little more than a year after a horrific accident in the Rio Olympics road race left her with three spinal fractures, the 34-year-old powered round the hilly 21.1km (13.1-mile) course in Bergen to win by a comfortable margin.
Despite rain making the course slippery, she averaged 43.8kmh for a time of 28 minutes 50.35 seconds.
Van Der Breggen, whose road race gold in Rio was overshadowed by the injuries sustained by her team mate who had been leading when she slammed into a deep gutter on a descent, was 12 seconds slower.
Australian Katrin Garfoot was third, as she was last year, 19 seconds behind.
Last year's champion Amber Neben of the United States could only manage 11th, while another Dutch rider -- Ellen Van Dijk -- second last year in Doha, was fifth.
Only five riders got within a minute of van Vleuten's time as she and Van der Breggen secured the first gold and silver from the same country in the time trial since 1996.
"I can't believe it," a tearful Van Vleuten said. "To be world champion in the TT, I never thought it would be, but this year I've started to believe.
"The downs make the ups more beautiful, makes it really special. It was hard because it started pouring with rain and I lost some seconds on the descents. I thought the weather would disturb my race form, but I focussed on what I do."
Van der Breggen was the second of the 54 riders to start and it looked as though she might take the gold as Van Vleuten was behind on the first two intermediate splits.
However Orica-Scott rider Van Vleuten put together a superb final 4km to go fastest on the scoreboard.
Eighteen riders followed her, including many of the pre-race favourites, but none mastered the conditions as well as Van Vleuten.
"I heard on the climb I was on almost the same time as Anna but in the last five kilometres I heard I was faster so I gave it everything to the finish," she said.
(Reporting by Martyn Herman; Editing by Christian Radnedge and John Stonestreet)
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