The Italian finished in 44 minutes, 29 seconds long the 20.6-kilometre (12.8-mile) along the uphill route from Mori to Polsa for his first stage victory in this year's race. Samuel Sanchez was 58 seconds behind. Damiano Caruso was third, 1:20 behind Nibali.
Nibali extended his lead to 4:02 over Cadel Evans and remains on course to win his country's biggest cycling race for the first time. There are three stages remaining.
Friday's 19th stage is the first of two more mountain legs, a 139-kilometre (86-mile) route from Ponte di Legno to Val Martello.
The Giro ends May 26 in Brescia.
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