Fox closed with a five-under 66 that looked like it might not be enough when Canadian Mackenzie Hughes came to the 18th hole with a one-shot lead.
But Hughes pulled his drive into the trees, had to pitch out and missed a 10-foot par putt for a 67 that put him in a playoff at 15-under 269 with Fox and Harry Higgs.
Higgs (68) missed a 25-foot birdie putt on the 18th with a chance to win for the first time.
Going back to the 18th for the playoff, Hughes and Higgs found the fairway and each had decent looks at birdie. Fox went from the rough to the collar right of the green. He raised both arms when the chip dropped for birdie.
Higgs and Hughes each missed their birdie putts.
The 38-year-old Fox had won three times on the European tour, including the flagship BMW PGA Championship in 2023, and has climbed as high as No. 23 in the world. But he had yet to record a top 10 on the PGA Tour this year.
The PGA Championship was holding a spot in the field at Quail Hollow for the winner of the Myrtle Beach Classic. This will be Fox's fourth straight year playing the major. Hughes was already in the field.
The victory also gives Fox a two-year exemption on the PGA Tour and a spot in The Sentry at Kapalua to start next year.
The tournament was played in the same week as the signature Truist Championship which attracted many of the tour's leading players.Â
