Bieber, who performed his “What Do You Mean?” hit to roaring cheers, was the biggest winner of the night, taking Best Male, Best Look, Worldwide Act: North America, Biggest Fans and Best collaboration for “Where Are U Now?” with Skrillex and Diplo.
The singer, who found fame at 13 and went on to become a global pop phenomenon, will next month release his first album in three years, during which bad behaviour offstage risked damaging his family-friendly teen heartthrob image.
“I don’t take any of these moments for granted,” Bieber said at the show. “That’s where I belong, right there on that stage.”
However several big names, also winners on the night, were absent from the event, held at Milan’s Mediolanum Forum.
No-shows included Taylor Swift, who won Best Song for “Bad Blood”, Rihanna who took Best Female, boy band One Direction who won Best Pop and Best Hip Hop winner Nicki Minaj.
But there were plenty of fireworks, light displays and visual effects from performers such as Ellie Goulding, who emerged from a cluster of mirrors to sing “Love Me Like You Do” and Jason Derulo whose dancers paraded on Segways.
The show, also broadcast in a virtual reality stream through an app, was hosted by “Orange is the New Black” actress Ruby Rose and British singer Ed Sheeran, who added Best Live Act and Best World Stage to his honours and performed with drum and bass band Rudimental.
Hip hop duo Macklemore and Ryan Lewis won Best Video for their hit “Downtown” which opened the ceremony in a “West Side Story” -inspired performance. They danced and jumped on stage as “Downtown” singer Eric Nally flew above belting out the chorus.
Italian tenor Andrea Bocelli gave pop fans a taste of the classical performing his well-known “Time To Say Goodbye” song.
Under a dimmed lighting, Bocelli received rapturous applause from the audience who sang along with him, before he launched into a duet with American singer Tori Kelly.
“Stitches” singer Shawn Mendes beat out British singers Jess Glynne and James Bay, who also performed on stage, for the Best New Act. Mendes was also an absentee at the show.
The sounds of the 1980s were remembered with Duran Duran receiving the first MTV Video Visionary award, which honours “the greatest pioneers in the history of the music video art form”.
Wrapping things up was Grammy Award-winning singer Pharrell Williams, who got the crowd on their feet performing his track “Freedom”.