Ruffo di Calabria's records for 1918 are incomplete, but credit him with four more victories. On 5 May 1918, he was granted the ultimate Medal of Military Valor, the Gold award. After Baracca's death on 19 June 1918, Fulco assumed command of the renowned "Squadron of Aces". He relinquished command of "91a Squadriglia" on 18 September to Ferruccio Ranza, after suffering a nervous breakdown. After recovery, he was handed command of "10th Gruppo", on 23 October 1918, but was shot down by artillery fire near Marano on 29 October 1918. In the end, he shot down 20 enemy airplanes in 53 combats, making him the fifth highest scoring Italian flying ace of World War I.