(Highlights from the MTV Europe Music Awards, courtesy MTV Networks International)
Fellow artists Katy Perry and Justin Bieber were also winners on a night dominated by US stars, with UK artists failing to convert their nominations.
Plan B, Alexandra Burke and Muse were among the acts who lost out
The ceremony was hosted by Desperate Housewives star Eva Longoria, who had 13 costume changes during the event.
One of her outfits included a costume shaped like a giant Spanish ham.
Lady Gaga was not in the Spanish capital to collect her awards in person and accepted them via satellite link from Budapest, Hungary where was appearing in concert.
'Big achievement'
The flamboyant star, who won best new act at last year's event, said: "This means so much to me, Europe, I love you.
"I hate not being there, I am working so hard."
Katy Perry, who won best video for California Gurls, arrived at the event with husband Russell Brand in their first public appearance together since marrying in India two weeks ago.
Presenter Eva Longoria appeared in numerous costumes Other award winners included best hip-hop act for Eminem, best alternative act for Paramore and best new act for Ke$ha.
(Presenter Eva Longoria appeared in numerous costumes)
Teen star Justin Bieber collected two awards for best male and best push act.
He called his best male win "a big achievement" and said the other artists in the category were "such an inspiration".
While UK stars lost out in the main categories, Marina and the Diamonds won best UK and Ireland act, ahead of Tinie Tempah, Ellie Goulding, Rox and Delphic.
The bash at Madrid's Caja Magica featured a number of live performances, including from Colombian star Shakira, rock veterans Bon Jovi and Rihanna, currently number one in the UK singles chart.
Bon Jovi collected a global icon prize marking their three-decades in the music business.
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