Racing from a lowered start due to fog in the upper part of the hill, Goggia sped down the bumpy Karnten-Franz Klammer course in gutsy style, beating the field by more than a second.
"I have never skied so strong and consistent in my whole life in a downhill," said the Italian after landing her third career victory. Last year, Goggia won both test events on the hill for the Pyeongchang Olympics.
"The snow I found here was exactly the same as in South Korea," said Goggia, who timed 1 minute, 4.00 seconds to beat Federica Brignone by 1.10 and Nadia Fanchini by 1.35.
"I am super happy for the podium because it's kind of an Italian party," she said, adding that her thoughts were with teammate Elena Fanchini. Nadia's older sister had to end her season to get treatment for a tumor.
"The victory is for me, for Elena, for Italy. We always have Elena in our thoughts," Goggia said.
Tiffany Gauthier of France missed the podium by 0.14 to finish fourth for a second straight day, matching her career best result.
Avoiding the risk of getting injured a month before the Olympics, American standout Lindsey Vonn held back throughout in a cautious run and was more than three seconds off the lead in 27th.
Due to poor snow conditions, the mandatory training run before a downhill was canceled in the last few days and was held on Sunday morning, two hours before the race.
It was the first time in the 51-year-history of the World Cup that the Italian team took the top three spots in a women's downhill.
The result came one day after Brignone won a super-G on the same hill. She also won a giant slalom in Lienz two weeks ago.
"I love Austrian slopes. Most of the time there are difficult conditions. I like it when it's icy and bumpy," said Brignone, who briefly considered skipping the season because of a persistent groin problem.
"We didn't understand what it was," she said. "We tried different things. It's not healed but for now it's under control."
Recovered from breaking an arm and hurting her spine in a crash a year ago, Fanchini got her first podium since winning in La Thuile, Italy, in 2016, which was her second win in an injury-marred career. She also placed fifth in the super-G.
Goggia praised Fanchini because "she has suffered so much during her career with all the injuries but she never gave up. Sometimes a fifth or third place means more than a victory."
Through Brignone as translator, Fanchini said she never thought she would "come back so strong" from the injury.
"Emotionally it was a tough moment for my family," she said, referring to Elena's illness. "Finishing third and fifth here, that is a dream."
In sharp contrast to the aggressive runs by the Italians, Vonn had a disappointing showing.
"I really had no grip on the ice, felt like I was skiing on marbles," said the American, who placed ninth in Saturday's super-G. "This course takes a lot of aggression and like really willing to risk everything. And I am just not willing to risk everything right now. I have been waiting eight years for the Olympics."
Vonn added she was "not necessarily disappointed in my result as it doesn't matter right now. What matters is that I am healthy and that I didn't end my season this weekend. Otherwise, you know, let's just forget about the whole weekend."
The women's World Cup continues with more speed races in Cortina d'Ampezzo, Italy, next weekend.
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