Gerrans, who has suffered four crashes this season, breaking his collarbone and fracturing his elbow, was first across the line as Orica-GreenEDGE clocked a best time of 19 minutes 26 seconds over 17.6 kilometres between San Lorenzo al Mare and San Remo.
The Australian team beat Alberto Contador's Tinkoff-Saxo by seven seconds, with the Spaniard the best placed of the top contenders after the first stage.
"We're very happy, we put a lot of work into this team time trial even if we're not a team of specialists," Australian Michael Rogers of Tinkoff-Saxo told reporters.
Contador is looking to become the first man to achieve a Giro/Tour de France double since the late Marco Pantani of Italy in 1998.
He leads Italian Fabio Aru, third overall last year, by six seconds after the local hope's Astana team took third place.
"I'm very happy with the way we rode. We can do anything during the race," Aru said.
Colombian Rigoberto Uran, runner-up in the last two editions, lies 12 seconds behind Contador after Etixx-Quick Step finished fourth 19 seconds off the pace.
Australian Richie Porte, Contador's main rival in the Giro, suffered a setback when Team Sky ended up ninth, 27 seconds behind the winners.
"You can get carried away during the whole first week about losing seconds. It's not ideal to lose time but it's not the end of the world," Porte said.
Sunday's second stage is a 177-km flat ride between Albenga and Genoa.
(Writing by Julien Pretot; Editing by Ed Osmond)
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