The musician, 72, lost his voice mid-way through his set at Auckland's Mount Smart Stadium on Sunday.
"I've just completely lost my voice. I can't sing," Sir Elton told the crowd. "I've got to go. I'm sorry."
Sir Elton appeared to break down in tears as he leaned on his piano and shook his head.
The audience gave the English singer a rapturous ovation as he walked gingerly off stage, helped by several assistants.
Earlier in his set, Sir Elton told the sold-out crowd he had been diagnosed with walking pneumonia on Sunday.
The concert was one of a number of New Zealand shows on Sir Elton's Farewell Yellow Brick Road tour.
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