Uruguay were named as International Swimming Federation (FINA) World Men's Water Polo Development Trophy champions after finalists Malta and Iran were both thrown out of the tournament following ugly scenes in Gzira.
Malta, the host nation, were playing the Iranians for the gold medal and led 8-6 with 44 seconds left to play.
The match was to end in disgrace, however, with provocation between both sets of players beginning in the pool and spilling to the sidelines.
Five Iranian players were sent off with two Maltese also given their marching orders.
Verbal exchanges carried on outside of the pool and players from both sides exited the water to join the fray as scenes became increasingly unsavory.
The officials abandoned the game 33 seconds from time before both sides were disqualified.
Uruguay, who had earlier beaten Saudi Arabia 11-5 in the bronze medal contest, were upgraded to gold.
Fifth-placed Austria are now the bronze medallists.
A FINA statement described the scenes as a "sad end for a great tournament".
"There were no punches or serious physical violence, the participants just yelled on each other amidst some pushing," the FINA match report said.
"Anyway, that should not be part of any water polo game which are supposed to be decided in the pool and not out of it."
A FINA statement added: "Uruguay was awarded the FINA World Men's Water Polo Development Trophy title in Gzira, Malta, after the host country team and 2015 trophy champions Iran were disqualified for unacceptable behaviour within the field of play.
"As Malta and Iran were competing in the pool for the gold medal, tensions started to erupt in and out of the water which led to the disqualification of both teams in accordance with FINA water polo rules.
"Following this unfortunate event, Uruguay won the title."
Water polo's most famous moment is perhaps the infamous "blood in the water" contest between the Soviet Union and Hungary at the 1956 Melbourne Olympic Games.
A particularly violent affair is remembered for Ervin Zádor being punched by Soviet Valentin Prokopov, with blood pouring into the pool.
Hungary won 4-0 in a game played after the 1956 Hungarian Revolution, which was crushed by Soviet forces.