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Born This Way is the 24-year-old's third US number one single, following her 2009 hits Just Dance and Poker Face.
The Hot 100 chart, which began in 1958, ranks songs by a mix of radio airplay, sales and streaming activity data.
Born This Way, which Lady Gaga performed at the Grammy awards last weekend, is only the 19th single to debut at number one in the Hot 100's history.
With digital sales of 448,000, the track also broke the record for the largest amount of downloads of a song by a female artist in its first week on release.
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