The Northern Irishman started six shots behind overnight leader Paul Casey, but seven birdies in a six-under-par 65 saw him finish two shots clear at 15 under.
England's Casey, 39, missed an eagle putt on the final hole at TPC Boston that would have forced a play-off.
It was 27-year-old McIlroy's first tournament win since the Irish Open in May and first PGA title since May 2015.
The victory comes just a week after he changed his putter and his putting coach.
He told Sky Sports: "I played some great golf and holed some great putts. I'm just really proud of myself, how I hung in there on the first day and then got some momentum on Saturday. Then I just went with it.
"It's nice to get that first win in the States this year and hopefully I can take this momentum into the next couple of weeks and ultimately the Ryder Cup."
The Deutsche Bank Championship is the second of the four that make up the season-ending FedEx Cup.
McIlroy will rise 34 places to fourth in the FedEx Cup standings - and nearer the $10m (£7.52m) prize for the winner - as a result of his victory.
The competition features the top 100 players in the world. The leading 70 after this weekend progress to next week's BMW Championship, where the field will be reduced to 30 for the Tour Championship on 22-25 September.
