Rafael Nadal won his 19th Grand Slam title after holding off Russian Daniil Medvedev's exhilarating fightback in one of the greatest US Open finals.

Spain's Nadal, 33, won 7-5 6-3 5-7 4-6 6-4 against the fifth seed in New York.

Nadal, seeded second, was cruising at two sets and a break up, only for Medvedev to force a decider.

But Nadal stopped his momentum to clinch a thrilling win in four hours and 50 minutes - just four minutes shorter than the longest US Open final.

Nadal's victory moves him within one of Swiss rival Roger Federer's all-time leading tally of men's Grand Slam victories.

"It has been one of the most emotional nights in my tennis career," Nadal said. "It has been an amazing final. It has been a crazy match."

After taking his third match point, Nadal collapsed to the court in celebration, covering his face as he contemplated another famous victory which epitomised his fighting spirit.

Medvedev, 23, trudged around the net to warmly congratulate his opponent, who looked on the verge of tears as he hid behind his sweat-soaked vest while taking rapturous acclaim.

"I just want to congratulate Rafa, a 19th Grand Slam title is something unbelievable, outrageous," said Medvedev, who looked mesmerised as he watched a video montage of Nadal's achievements.

Those lucky enough to be watching among a near-24,000 capacity crowd were regularly left open-mouthed at what they witnessed, with the majority jumping to their feet and celebrating wildly after every point, helping create an electric atmosphere on a noisy Arthur Ashe Stadium.

Medvedev had been booed by the crowd earlier in the tournament, yet heard his name loudly chanted by many as he threatened to complete an extraordinary comeback.

Ultimately it was too late as he was unable to become the first man outside Nadal, Federer and Serbia's world number one Novak Djokovic to claim one of the sport's biggest prizes since Stan Wawrinka's victory here in 2016.

Nadal, Federer and Djokovic have won the past 12 Grand Slams after the Spaniard lifted the trophy in New York for a fourth time.

Now Nadal has the chance to draw level with 38-year-old Federer, who was nine titles better off than his long-time rival in 2007, at the Australian Open in January.