Best Show Garden and a Gold medal were awarded to 'The Macmillan Legacy Garden', designed and built by Mark Eveleigh, while 'The Water Spout' by Christian Dowle of Garden Inspirations was awarded Best Festival Garden and took home Silver-Gilt.
Eveleigh said he was "delighted" to be taking the top title, adding that the award "represents an enormous pat on the back from the industry I'm so proud to be a part of".
His design was inspired by an overgrown formal garden in Worcestershire, which was built in 1911, the same year as Macmillan Cancer Support was founded.
Eveleigh said: "This year we really have done all that we can to bring a spectacular show garden to RHS Malvern. I'd like to take this opportunity to thank the team behind the show garden for their tremendous work and support along the way.
"It's been a great privilege to create this garden for Macmillan. I cannot wait to share the garden with the great many visitors of RHS Malvern Spring Festival."
Judging took place on 4 May, just one day before the festival opens to the public. Gardens were judged by an RHS panel formed of Dougal Philip (chair), Paul Hervey-Brooks and Richard Barnard as Garden Assessing Judges, along with Stephen Woodhams (Chair), James Alexander-Sinclair, Christopher Bailes and Arne Maynard as Garden Judges.
Judging of the Professional Show Gardens takes into consideration delivery, design, atmosphere, planting and construction. The RHS Floral Judging is based on overall impression, plants and endeavor.
Ken Nottage, chief executive of Three Counties, said: "Quite simply, the talent speaks for itself this year. 2016 sees the Show Gardens take up more space than ever before and the talent has matched the bigger spots going more grand and elaborate than we could ever have imagined.
"This is the time when RHS Malvern Spring Festival really comes into its own. The hard work is done and it's time to sit back and appreciate the unimaginable efforts that go into bringing these spectacular designs to life. I'd like to take this opportunity to congratulate the many winners we have this year and also thank them for their immense contributions of bringing the theatre to RHS Malvern Spring Festival."
Voting is now open for the People's Choice award at www.rhs.org.uk/malvernpeopleschoice. The show runs until 8 May with the award announced on 6 May.
Gold medal winners:
'Macmillan Legacy Garden' by Mark Eveleigh in support of Macmillan Cancer Support
'The Sunken Retreat' by Graduate Gardeners
'Reflections of Japan' by Peter Dowle and Richard Jasper of Howle Hill Nursery
'Garden of Romance' by Villaggio Verde
'Garden amidst ruins, a homage to Capability Brown' by Todd Longstaffe-Gowan Landscape Design and Wyevale Garden Centres in partnership with Historic Royal Palaces.
Silver-Gilt medals winners:
'The UCARE Garden' by Emily Sharpe of Garden Stories
'The Water Spout' by Christian Dowle of Garden Inspirations
Silver Medal winners:
'Milleflori "A Garden of One Thousand Flowers" ' by RHS students of CW Horticultural Training
'The Woodcutter's Garden' by Mark Walker Landscapes
Bronze Medal winners:
'Time is a Healer' in support of The Primrose Hospice by Martyn Wilson