The 41-year-old was competing just nine days after rupturing ligaments in her left knee, but hitting the gate with her ski pole on a first jump left Vonn off balance, denying a fairytale ending to a remarkable story.
Vonn was airlifted off the piste to Ca Foncello hospital in Treviso, around 130km from Olimpia delle Tofane in the Dolomites, following lengthy treatment.
The hospital issued a statement which said she had orthopedic surgery to stabilize the fracture she sustained in her left leg - the same leg with the torn anterior cruciate ligament (ACL).
Earlier, a statement from the United States ski team said Vonn had sustained an injury but was in a stable condition.
The two-time world champion had successfully completed two training runs on the iconic course prior to Sunday's crash.
Compatriot Breezy Johnson was in tears as she added Olympic gold to the world title she won last year after clocking a blistering time of one minute 36.10 seconds.
The 30-year-old watched on the big screen at the finish line with her head in her hands when her teammate crashed, having completed her run sixth, while Vonn was 13th to go.
Another American, Isabella Wright, watched the crash from the top of the slope before having to complete her own run but said she had hoped Vonn would be able to complete the race despite the ACL injury she sustained nine days ago.
If anyone can, Lindsey can. Whatever it is, or whatever the situation, she's very strong. We're going to support her the best we can, she said.
She deserved a better ending than that so I'm heartbroken for her. I hope to see her and just support her. I know she's in good hands right now. [I'm] anxiously waiting to see her.
Germany's Emma Aicher was pipped by 0.04 seconds and took the silver medal, while Italian home favourite Sofia Goggia secured bronze.
Vonn was taking a huge risk by competing on Sunday, having suffered the ACL injury in Switzerland in the last World Cup race before the Games, but was determined to take to the course for her favoured event.
Stunned spectators applauded towards the helicopter as it carried her away from the piste which has brought her so much success - with 12 of her 84 World Cup wins coming here.
It is now unlikely she will compete in those events, meaning her Olympic career has almost certainly come to a devastating end.
Vonn had appeared relaxed in the training runs and in the morning before the race. Her coach Aksel Lund Svindal said on Friday he felt confident she could pull off something spectacular.
No stranger to a comeback, Vonn retired from the sport in 2019 as the most decorated female skier at the time but had suffered several serious leg injuries.
She made a shock return to the sport in 2024 after a partial right knee replacement, competing at her fifth Olympics following a successful 2025-26 season, in which she reached the podium in all five races, winning two.
But this latest crash leaves a significant doubt over whether Vonn will ski competitively again. Johnson, who has suffered serious leg injuries of her own, said Vonn's coach had told her she was cheering her teammate on from the helicopter.
The work that we put in, obviously my heart aches for her, Johnson said.
Vonn knew the dangers of competing but showed defiance in a media conference earlier this week, and had even hit back at a doctor on social media who claimed the injury was not a fresh tear.
She responded by saying her ACL is 100% torn and had hoped to defy the odds by replicating the Olympic downhill gold medal she won in Vancouver in 2010.
What we saw [is] that the top of the piste is really hard for a fit athlete. It is brutal - think about her family, her team and herself, said four-time British Olympian Chemmy Alcott, who was emotional on BBC coverage. We have to be realistic - the risk was really high, the risk she takes when she falls will double that. Her body will not be able to take that.
