Quintana did enough in the final time trial to retain his race lead, beating second-placed Bauke Mollema (Trek) by 18 seconds in the general classification. Rigoberto Uran (Etixx-QuickStep) placed third overall at 31 seconds.
“I needed this win for my own head, but also to show my fans that I am still here," Quintana said after the win. "Last year I won the Vuelta a Burgos, but then in the Vuelta a Espana I couldn’t give my fans the satisfaction of the win because of that disastrous fall. To finish on the podium in Argentina [Tour de San Luis] was reassuring, although it’s a very different type of race and lacks the big rivals who go to the WorldTour races.
"It was fantastic to come here, to find my team in great form and ready to work hard, and to come away with victory: it is emotional, and good for the head.”
Britain's Steve Cummings (MTN-Qhubeka) put in a solid ride to finish eighth on the stage and moved up to sixth overall, just one second behind Alberto Contador (Tinkoff-Saxo). Adam Yates (Orica-GreenEdge) was the second British rider in the top 10, finishing in ninth.
Touted as one of the pre-race favourites, 2012 and 2013 Tirreno winner Vincenzo Nibali (Astana) finished the 2015 race in 16th spot, two minutes adrift of Quintana.
Fabian Cancellara (Trek) signalled his improving form ahead of the spring classics by taking the stage win, posting a time of 11 minutes and 23 seconds over the 10-kilometre course in San Benedetto del Tronto.
Cancellara got his revenge on stage one time trial winner Adriano Malori (Movistar), beating the Italian by four seconds. Sky's Vasil Kiryienka finished in third at nine seconds.
Mark Cavendish (Etixx-QuickStep) was a non-starter after withdrawing during the previous day's stage. The Manxman will now aim for a second victory in Milan-San Remo on Sunday, which is where many of the riders who took part in Tirreno-Adriatico will now be heading.
Tirreno-Adriatico 2015, stage seven: San Benedetto del Tronto, 10km ITT
1. Fabian Cancellara (Swi) Trek Factory Racing in 11-23
2. Adriano Malori (Ita) Movistar at 4 secs
3. Vasil Kiryienka (Blr) Sky at 9 secs
4. Jonathan Castroviejo (Spa) Movistar at 12 secs
5. Maciej Bodnar (Pol) Tinkoff-Saxo at 16 secs
6. Michael Hepburn (Aus) Orica-GreenEdge at 16 secs
7. Ramunas Navardauskas (Ltu) Cannondale-Garmin at 17 secs
8. Steve Cummings (GBr) MTN-Qhubeka at 23 secs
9. Andrey Amador (Crc) Movistar at 25 secs
10. Edvald Boasson Hagen (Nor) MTN-Qhubeka at 26 secs
Final overall classification
1. Nairo Quintana (Col) Movistar
2. Bauke Mollema (Ned) Trek Factory Racing at 18 secs
3. Rigoberto Uran (Col) Etixx-QuickStep at 31 secs
4. Thibaut Pinot (Fra) FDJ at 35 secs
5. Alberto Contador (Spa) Tinnkoff-Saxo at 39 secs
6. Steve Cummings (GBr) MTN-Qhubeka at 40 secs
7. Wouter Poels (Ned) Sky at 56 secs
8. Domenico Pozzovivo (Ita) Ag2r at 59 secs
9. Adam Yates (GBr) Orica-GreenEdge at 1-09
10. Roman Kreuziger (Cze) Tinkoff-Saxo at 1-11
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