Rafael Nadal overcame a fightback for the ages from first-time Grand Slam finalist Daniil Medvedev to claim his fourth US Open title on a night of high drama in New York.

Taken to a fifth set after leading by a break in the third, Nadal held on for a 7-5 6-3 5-7 4-6 6-4 victory in four hours and 49 minutes of spellbinding action, just five minutes shy of the longest US Open final in history.

The Spaniard broke down in tears shortly before the trophy ceremony as the screens around Arthur Ashe Stadium paid tribute to his 19Grand Slam titles, just one shy of Roger Federer’s 20, the current men’s singles record haul.

"This victory is so important for me, especially as the match became more and more difficult," Nadal said during the trophy presentation. "I was able to hold the nerves. They were so high. It was a crazy match and I'm just very emotional.

"It was an amazing final. Daniil is only 23 years old, and the way he was able to fight and change the rhythm of the match was amazing. He will have many more opportunities like this."

Nadal led Medvedev by two sets and a break and was seemingly on course for a second straightforward victory over the Russian in a month, having cruised to the Rogers Cup title in Montreal in their first encounter for the loss of just three games.

But even at that stage the match was far closer than Nadal’s lead suggested, and when Medvedev broke straight back to level up at 3-3 in the third the crowd energised the 23-year-old, who ramped up the aggression and produced some of his best tennis to break once more and force a fourth set.

As much a test of nerve and tactical nous as it was a battle of wills and resilience, both men were forced to dog deep into their arsenals and athletic reserves to stay in touch with one another throughout the intense contest, producing a hefty collection of highlight-worthy rallies and winners.

Like Nadal, Medvedev initially looked to play from deep behind the baseline on return, but he also hared forward to the net far more than he has in the past, showing some inspired touch and refusing to be overawed by the occasion.

Nadal fended off a break point early in the fourth but after failing to find a way through himself, he was undone in the 12^th game as Medvedev forced a decider, cheers from the stands flooding down for both men as the match approached its fifth hour.

The Russian’s serve and forehand had dragged him back into the contest, but the physical cost began to catch up with him in the fifth as he had work on his left thigh, already taped ahead of the match. Nadal was quick to take advantage, breaking twice to move 5-2 up with the chance to serve for the title.

Again, Medvedev refused to go quietly. Breaking to stay in the final, he survived two match points at 3-5 and even brought up a break-back point at 5-4. But Nadal was not to be denied, collapsing to the court after Medvedev’s final return sailed long to seal victory.

"Because of the crowd, I was fighting like hell," Medvedev said. "In the third set, in my mind, I was already thinking what to say in the speech. I didn't give up, but unfortunately it didn't go my way."

Nadal now joins John McEnroe with four US Open titles, trailing only Federer, Jimmy Connors and Pete Sampras on five – and this, his first five-set final win in New York, will live long in the memory.

"The last three hours of the match were very, very intense," Nadal said. "Very tough mentally and physically, too. The crowd has been as always amazing, all these facts that make the moment super special. It was an unforgettable moment.

At the same time Daniil created this moment, too. The way that he fought, the way that he played, he is a champion. Just well done for him. I really believe that he will have many more chances.

"The way that the match became very dramatic at the end, that makes this day unforgettable, part of my history of this sport. I'm just very happy. This trophy means everything to me today."

Earlier on Sunday, Aryna Sabalenka and Elise Mertens claimed the women's doubles title, their first Grand Slam doubles triumph together, with a 7-5 7-5 victory over Victoria Azarenka and Ashleigh Barty, who was bidding to defend her 2018 crown.