The former president and Republican contender pushed the audience to deliver an Election Day win, which he linked to his survival from the shooting.
He began his speech with, “As I was saying,” and gestured toward an immigration chart he was looking at when the gunfire began.
“Twelve weeks ago, we all took a bullet for America,” Mr Trump said.
“All we are all asking is that everyone goes out and votes. We got to win. We can’t let this happen to our country.”
The Mr Trump campaign worked to maximise the event’s headline-grabbing potential with just 30 days to go and voting already underway in some states in his race against his Democratic opponent, Vice President Kamala Harris.
Musician Lee Greenwood appeared on stage and serenaded him with God Bless the USA, frequently played at his rallies, and billionaire Elon Musk spoke for the first time at a Trump rally.
“We fought together. We have endured together. We have pushed onward together,” Mr Trump said. “And right here in Pennsylvania, we have bled together. We’ve bled.”
At the beginning of the rally, Mr Trump asked for a moment of silence to honour firefighter Corey Comperatore, who died as he shielded family members from gunfire in July.
Classical singer Christopher Macchio sang Ave Maria after a bell rang at the same time that gunfire began on July 13.
Several of Mr Comperatore’s family members were in attendance, including his widow, Helen, who stood during Mr Trump’s remarks next to the former president’s daughter-in-law, Lara Trump.
Standing behind protective glass that now encases the stage at his outdoor rallies, Mr Trump called the would-be assassin “a vicious monster” and said he did not succeed “by the hand of providence and the grace of God.”
There was a very visible heightened security presence, with armed law enforcers in camouflage uniforms on roofs.
Mr. Trump honored Mr. Comperatore and recognized the two other injured rallygoers from July, David Dutch and James Copenhaver.
They and Mr. Trump were hit when 20-year-old shooter Thomas Matthew Crooks of Bethel Park, Pennsylvania, opened fire from an unsecured rooftop nearby before being fatally shot by sharpshooters.
The building from which Crooks shot was totally concealed by tractor trailers, a broad grassy border, and a fence.
Crooks’ ability to outmanoeuvre law enforcement that day and scramble on top of a building within easy shooting distance of the former president is one of many unanswered questions about the worst Secret Service security failure in decades.
Another aspect is his motivation.
