The performance of a waterfall-type cross-flow hydraulic turbine was investigated via experiment and numerical simulation. The experiment was carried out using a cross-flow hydraulic turbine operating in a two-dimensional waterfall, and the result was compared with a corresponding numerical result analyzed by the volume of fluid method. The experimental results show that the maximum efficiency reached approximately 60%, higher than that of previous experiments in the literature. It was also confirmed that the recorded experimental efficiency was well reproduced in a two-dimensional numerical simulation, suggesting the validity of the numerical results. Furthermore, flow fields of the turbine were studied based on phase-averaged particle image velocimetry measurement and the numerical simulation. These results indicate that the flow and torque mechanisms of the cross-flow hydraulic turbine studied are explained by stagnation pressure on the concave side of blades and a Coanda-like flow on the convex side of the blades at small angle of blade position, followed by the formation of a high-velocity region within the turbine and flow impingement on the downstream blades at large angle. These flow field variations generated an increased local torque at small angle and a moderate torque at large angle. The improved efficiency was obtained by optimizing the off-axis distance to the waterfall and the tip-speed ratio of the hydraulic turbine, which were examined by a visualization of the flow through the turbine and the local torque distribution with respect to the angle of blade position, respectively.