Elton has won the first ever Brits Icon award, in a gala concert which marked his stage return after surgery for appendicitis.
The musician was presented with the prize by his friend, Rod Stewart, who described him as "the second-best rock singer ever."
The former Reg Dwight said he was "flattered" by the accolade, given to artists who have had a "lasting impact" on UK culture.
He also played some of his hits, including Your Song and Philadelphia Freedom.
Students from the Royal Academy of Music, where Elton trained, joined him on stage to play Home Again, from his new album The Diving Board, while Stewart duetted with his colleague on Sad Songs (Say So Much).
Holding it aloft, he quipped: "They've even made it sparkly on the bottom, which you know I love".
He dedicated the award to writing partner Bernie Taupin, "who I wouldn't be here without", as well as the "Women's Institute and you, the fans".
He said he would not curtail his touring schedule as he was "addicted to playing live."
"I've played 92 countries, and I want to play 100," he continued. "That's just the way I'm programmed".
The two-and-a-half-hour concert took the form of a career retrospective, with O'Leary interviewing the luminary about his career in between songs.
He discussed growing up in the "secretive" 1950s and how he had been forced to abandon any hope of becoming a classical pianist because his "hands are too small."
Elton cringed as footage from his infamously bad-tempered fly on the wall documentary Tantrums and Tiaras was played, and was keen to stress he had put his "little demons" to rest.
"I'm not a diva any more," he declared. "I like things a certain way but it's called professionalism, I think."
Prior to Monday's show, Elton had already won two Brits for outstanding contribution to the music industry, as well as the Freddie Mercury memorial award for his charity work.
Proceeds from the Icon award show will go to the Brit Trust, Text Santa and the Royal Academy of Music.
The highlights will be shown on ITV on September 13.