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Kristupas Zemaitis scored an extra-time jump-shot from beyond the arc to earn the gold medal.
Zemaitis is mobbed by his Lithuania team-mates after netting the winning shot
The last-ditch drama sparked wild celebrations on the court as Lithuania savoured an 18-16 triumph over France in the Nanjing 2014 Youth Olympic Games final, but Zemaitis refused to take the credit.
“All my team-mates are the heroes,” he said. “The luck was in the ending and I believed I would make the shot and I did.”
“It was an incredible shot," said Jonas Leksas. “It’s impossible now to believe that we’re going to hear our anthem.”
Zemaitis had put his side ahead by one with 10 seconds left in regulation time but France tied the game at 16-16 with four seconds left on a lay-up by Lucas Dussoulier to force extra time.
Under tournament rules, the first team to lead by two points wins, and Zemaitis made himself the hero with his clutch shooting, as retired basketball star Yao Ming of China and IOC President Thomas Bach watched on.
Samuelson stars in US triumph
Earlier, Katie Lou Samuelson cemented her reputation as one of the top teenage players on the planet with a game-high eight-point performance to lead the USA to a 19-10 win over the Netherlands in the gold medal game.
“Mission accomplished," Samuelson said. “We worked so hard to get here and our mindset was we were not going to let another team take this from us."
Spain took bronze on the women’s side with a 12-11 win over Hungary, while Argentina beat Russia 17-14 in the men’s bronze medal match.
Both gold medal-winning teams finished the tournament undefeated.
The USA celebrate securing the gold medal in the women's final
France had shown up well in the men's final and were not too disappointed with silver.
“It was wonderful, we played the entire game very hard,” said Teddy Cheremond. “We didn’t think we could do it and in the end we just tried to play hard all the way through the overtime.”
“It’s been a great experience here the last two weeks and this was a great way to finish it off,” said US player Napheesa Collier.
“We just got along really well and the chemistry we had as a team was one of the main reasons we won.”