Coke, 43, pleaded guilty to drug and gun-trafficking charges in August 2011.
A five-week operation to capture him in 2010 saw clashes in Jamaica's capital, Kingston, in which scores died.
His Kingston-based criminal organisation trafficked marijuana, cocaine and firearms and enjoyed protection from Jamaica's ruling party.
When Coke was first indicted in the US in 2009, Jamaican Prime Minister Bruce Golding initially fought his extradition, arguing that it was based on flawed evidence.
Mr Golding's parliamentary constituency is in West Kingston's Tivoli Gardens, the district Coke's Shower Posse and the Presidential Click had controlled.
But after months of delays and amid growing local and international criticism, Mr Golding agreed to extradite Coke and signed an arrest warrant.
Coke was handed 20 years on the trafficking charge and three for conspiracy to commit assault with a dangerous weapon.
Coke had written a letter to the judge ask for leniency, describing good deeds he said he did for slum-dwellers in Tivoli Gardens.
In court on Friday, he sat stoically in grey prison clothes, and briefly told Judge Robert Patterson: "I am a good person".
Prosecutors argued Coke terrorised and destroyed anyone who interfered with his drug operation, and several women abused by his gang in Jamaica begged the judge for a harsh punishment.
But many of his supporters in impoverished parts of Kingston describe him as a benefactor.
Earlier this week, prosecutors had said Coke was so powerful that he enjoyed "virtual immunity from the reach of law enforcement."
Coke's lawyer, Stephen Rosen, said he believed Coke would be released in his 60s and allowed to return to his home country.
He said his client will not appeal against the sentence.
Source: BBC News
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