Understanding how potent neutralizing antibodies (NAbs) inhibit SARS-CoV-2 is critical for effective therapeutic development. We previously described BD-368-2, a SARS-CoV-2 NAb with high potency; however, its neutralization mechanism is largely unknown. Here, we report the 3.5-Å cryo-EM structure of BD-368-2/trimeric-spike complex, revealing that BD-368-2 fully blocks ACE2 recognition by occupying all three receptor-binding domains (RBDs) simultaneously, regardless of their “up” or “down” conformations. Also, BD-368-2 treats infected adult hamsters at low dosages and at various administering windows, in contrast to placebo hamsters that manifested severe interstitial pneumonia. Moreover, BD-368-2’s epitope completely avoids the common binding site of VH3-53/VH3-66 recurrent NAbs, evidenced by tripartite co-crystal structures with RBDs. Pairing BD-368-2 with a potent recurrent NAb neutralizes SARS-CoV-2 pseudovirus at pM level and rescues mutation-induced neutralization escapes. Together, our results rationalized a new RBD epitope that leads to high neutralization potency and demonstrated BD-368-2’s therapeutic potential in treating COVID-19. Display omitted •BD-368-2 blocks all three ACE2 binding sites regardless of RBD spatial conformations•BD-368-2 treats severely infected hamsters at low dosages and various dose windows•New cocktail design based on BD-368-2 neutralizes escaping SARS-CoV-2 mutants Du et al. showed how a potent COVID-19 antibody, BD-368-2, interacts with the SARS-CoV-2 spike trimer to neutralize the virus and effectively treat severely infected hamsters. They further demonstrated how BD-368-2 can be paired with additional antibodies to form a cocktail that prevents the evolution of viral escape mutants.