But the embarrassing fallout from her first Brits appearance in 20 years eclipsed the success of Smith and Sheeran, who took two awards each.
Smith won the British breakthrough act and global success awards, capping a trophy-filled month after he won song of the year at the Grammys for Stay With Me.
Sheeran went home with the awards for best British male solo artist and album of the year for X.
"This is incredible, I really didn't expect this," Smith told the crowd, while Sheeran called it a great night for British music that defied those who said "selling records is dead".
The hosts of the Brit Awards, Ant and Dec, joked on Twitter after the show that they were stuck in a hospital emergency ward with Madonna.
Another British TV presenter, Matt Johnson, quipped: "Cape Calm And Carry On".
British celebrities were generally supportive of Madonna, highlighting the pop icon's long career as a superstar.
But many ordinary fans on the social media site were more cruel, joking that the pop veteran had fallen because of her age and should consider investing in a stairlift to help her navigate steps in future.
The Guardian newspaper said that the fact the "truly stunning tumble" had drawn so much attention was a damning indictment of the show itself.
"If the ceremony proved anything, it was that the Brit Awards themselves are substantially less interesting than watching someone fall over," it said.T
he awards show kicked off with a rendition of Blank Space by Taylor Swift, who won the international female solo artist award.
She paid tribute to Sheeran, "who took me to pubs and taught me to make a good cup of tea and taught me everything I know about the UK".
Rapper Kanye West was welcomed onstage by his wife Kim Kardashian.
But the showcase of his new track All Day caused confusion among television viewers as much of it was muted in an attempt by broadcaster ITV to silence its repeated use of the N-word.
Veteran "man band" Take That also performed live, as did rockers Royal Blood, who won the best British group award.
Best single went to Mark Ronson for Uptown Funk while Paloma Faith was named best British female solo artist and Foo Fighters were best international group.
- AFP
