The Italian’s time of 24min 50.22sec over the 16km course was good enough to clinch victory from Norbert Mosandl of Germany, who finished 27sec behind, and US rider Oscar Sanchez, who was 45sec back.
Zanardi, a former F1 pilot for Minardi and Lotus who also drove in Indy and touring car races, was critically injured and had to have both legs amputated after a horror smash in 2001.
He battled back into sport, even competing in a touring car race at Brands Hatch in a specially-adapted car with hand controls before turning his attention to hand-cycling.
Mumbai Roundup: 9 incidents that took place this week
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Photos: Kareena Kapoor Khan's grand birthday bash
Photos: 'Dangal' girls Sanya Malhotra, Fatima Sana Shaikh's dinner outing