Ironically it was the director's first feature-length film in English, "The Room Next Door", that won him the Golden Lion, even if he had received a career award from Venice in 2019.
"The Room Next Door" sees regular Almodovar collaborator Tilda Swinton as a war correspondent suffering from terminal cancer, with Julianne Moore as her friend who stays with her in the final days.
"It is my first movie in English but the spirit is Spanish," Almodovar said after receiving the award, where he made an appeal for dying with dignity to be a "fundamental right".
Long synonymous with subversive stories that mixed humour, transgression and lots of drugs and sex, Almodovar's works are increasingly tormented by physical decline and the fear of death.
To explain this new seriousness, the 74-year-old often evokes his life as an ageing man, living increasingly as a recluse with his cat.
Almodovar burst onto the international scene with his 1988 Oscar-nominated "Women on the Verge of a Nervous Breakdown", a dark kitschy comedy about a woman who had just been dumped by her lover and whose apartment becomes the scene of hostage situations and accidental overdoses.
Once asked about the "masochism, homosexuality, masturbation, drugs, porn and attacks against religion" that seemed to characterise his films, he replied: "All of these themes that are considered taboo belong to my life.
"I don't consider them to be prohibited or scandalous," the director added.
But for more than a decade, Almodovar has been embracing a more poignant tone in his work.
His "Pain and Glory" from 2019 featured Antonio Banderas playing an ailing director that the filmmaker has acknowledged was modelled on himself.
- Mother as muse -
One of the leaders of the "Movida", the explosion of creativity that followed the death of longtime Spanish dictator Francisco Franco in 1975, Almodovar is openly gay.
He soon became a symbol and chronicler of a modern and tolerant Spain that he also helped create.
Born in 1949 in the arid region of La Mancha in the centre of Spain, he rarely talks about his father, who died in 1980.
But he grew up in the company of women and his mother has been a key reference throughout his life, with maternity a recurring theme of his movies, particularly in his 1999 masterpiece, "All About My Mother".
"My passion for colour is a response to my mother who spent so many years in mourning and blackness that goes against nature," he once said.
His debut feature film, the 1980 camp comedy "Pepi, Luci, Bom and Other Girls Like Mom", captured the newfound cultural and sexual freedom of the time.
He was one of the first directors to include transgender characters in his movies, including in "All About My Mother", which won the Oscar for best foreign language film.
He won a second Oscar for best original screenplay for his 2002 film "Talk To Her".
The 81st edition of the concluded on Saturday with the award ceremony.
Awards: Venice81
Here are the main winners from among 21 films in competition of Venice Film Festival, as decided by a jury chaired by French actor Isabelle Huppert:
- Golden Lion for Best Film - "The Room Next Door" by Pedro Almodovar (Spain)
- Silver Lion Grand Jury Prize - "Vermiglio" by Maura Delpero (Italy, France, Belgium)
- Silver Lion award for best director - Brady Corbet for "The Brutalist" (UK)
- Volpi Cup award for best actress - Nicole Kidman for "Babygirl" by Halina Reijn (US)
- Volpi Cup award for best actor - Vincent Lindon in "Jouer Avec Le Feu" by Delphine Coulin and Muriel Coulin (France)
- Award for best screenplay - Murilo Hauser and Heitor Lorega for "I'm Still Here" by Walter Salles (Brazil, France)
- Special jury prize - "April" by Dea Kulumbegashvili (France, Italy, Georgia)
- Marcello Mastroianni Award for best young actor or actress - Paul Kircher for "Leurs Enfants Apres Eux" by Ludovic Boukherma and Zoran Boukherma (France)
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