Sir Elton objected to Madonna's nomination for a live award
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Sir Elton John has accused Madonna of cheating fans by miming on stage, while collecting a Q Award for songwriting.
As he collected his Classic Songwriter prize in London on Monday, he criticised live award nominee Madonna.
"Anyone who lip-synchs in public on stage when you pay £75 to see them should be shot," Sir Elton said.
Muse won best live act while the Red Hot Chili Peppers won best act in the world and Roxy Music took the Lifetime Achievement award from Q magazine.
Liz Rosenberg, Madonna's US press agent, denied that the star used lip-synching when performing live.
"Nor does she spend her time trashing other artists," she said.
"She sang every note on her Re-invention tour live."
Elton John said his comments would mean he would no longer be on Madonna's Christmas card list.
But Ms Rosenberg added: "Elton John remains on her Christmas card list whether he is nice.... or naughty."
While collecting the award, Roxy Music frontman Bryan Ferry expressed support for his pro-hunt protester son, Otis.
The 21-year-old invaded the House of Commons with four friends last month in protest over the government's bill to ban fox-hunting.
"I would like to dedicate this award to my brave son
Otis," said Ferry, whose speech was met with muffled boos.
Keane's Hopes and Fears was named best album, Franz Ferdinand's Take Me Out won the best video prize and Razorlight were named best new act.
Triple Mobo winner Jamelia took home the best single award for See It In A Boy's Eyes, written with Coldplay's Chris Martin.
The Grosvenor House Hotel music magazine event was attended by musicians including U2, the Pet Shop Boys and Elvis Costello.
Sir Elton's outburst came after he branded Taiwanese photographers "rude,
vile pigs" at an airport last month.
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Q Award winners 2004: