The Olympic champion led a strong Italian showing on the Mont Lachaux in Crans Montana, Switzerland, a hill on which she is unbeaten in downhills after a win in 2019 and also on Friday.
In slightly better conditions than Friday's race, which was disrupted by wind, Goggia ruled the slopes to finish 0.27 seconds ahead of home favourite Lara Gut-Behrami and fellow Italian Elena Curtoni (+0.60).
Another Italian, Laura Pirovano, placed fourth.
Czech skier Ester Ledecka, who was second on Friday, was looking fast on her run and clocked the fastest speed at the speed trap before suffering a high-speed crash into the safety netting at around 109 km/h, although she was quickly back on her feet and gave a thumbs up to signal she was okay.
The result extends Goggia's red bib lead in the downhill standings and moves her up to third on the overall World Cup leaderboard.
Goggia's win equals Isolde Kostner's Italian World Cup women's record of five straight downhill podiums, set in 2001/02.
Her four wins followed a runner-up finish in the season's opening downhill in Val d'Isere, France.
Gut-Behrami was quick out of the gate and found herself up on Goggia at the first timing intermediate, and although she dropped a bit of time in the middle segment, the Swiss star gained it back on the faster section in the last third of the course, closing to within three-tenths of Goggia.
Curtoni made no real errors on her run and stayed close to her teammate's time during her run, but a poor line into and out of the final jump lost crucial tenths on Gut-Behrami as she finished third.
Meanwhile, the men's classic downhill race down the Streif on the Hahnenkamm in Kitzbühel, Austria, was postponed to Sunday because of weather. An additional day of racing was added to the weekend, with the Super-G scheduled for Sunday pushed to Monday.