Five men had remained in the reckoning for the downhill crown with Fill -- who has had only two podium finishes this season -- tied at the top with injured Norwegian Aksel Lund Svindal ahead of the final race.
Tenth place was all Fill needed, the Italian ending up with 462 points to Svindal's 436 in a race won by Switzerland's Beat Feuz. American Steven Nyman finished second and Canadian Erik Guay was third.
"I think we are a strong team. Now is the first time that we have the downhill globe and maybe now we continue in this way," said Fill, who won the race in Kitzbuehel in January where Svindal tore a cruciate ligament.
The race start had been delayed by 30 minutes due to fresh snow on the piste and visibility was poor by the time Fill left the start.
"I was completely concentrated on my race," he said. "The coach said to me the conditions are perfect, good visibility. And when I put my sticks out of the start gate I saw 'Oh, what's happening here? It's not really good light.
"It was hard to go down but it was enough."
In the women's race, Austrian Mirjam Puchner took her first career World Cup victory ahead of Switzerland's Fabienne Suter and Italian Elena Curtoni.
American Lindsey Vonn had already won the women's downhill World Cup title before being sidelined by a knee injury that ended her overall World Cup hopes.
"I felt like I had a really great year – nine wins – and to be able to still take home one Globe at least, even though I had to end my season early, it means a lot," said Vonn, who watched the race before being handed her eighth career downhill globe.
Vonn still leads the Super-G standings by 19 points but Gut can deny her that globe on Thursday when the women race the final speed event of the season.
"I worked so hard and was so close -- I was leading four titles when I got hurt -- so to still have at least one (Globe), that was huge and I’m pretty excited about it."
Gut finished 13th in Wednesday's downhill and is now assured of the overall title with three races and 300 points remaining to be won.
The Swiss has 1,382 points to Vonn's 1,235 with Germany's Viktoria Rebensburg on 1,007.
(Writing by Alan Baldwin in London, editing by Pritha Sarkar)
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