Low operating voltage is highly attractive for medium-power millimeter-wave gyrotrons since it can reduce their size and cost, increase their safety, and, thus, improve usability for applications. However, at low voltages, the voltage depression caused by DC space-charge fields significantly limits the electron current and transverse power in the beam. Moreover, this current limitation is more pronounced for a beam with a higher pitch factor. As a result, for a given anode voltage, there is a pitch factor at which the transverse beam power in the gyrotron cavity is the maximum. This ultimate transverse power is found analytically in the non-relativistic approximation. Such a power is reached when the pitch factor calculated without taking into account voltage depression is only 0.82; voltage depression decreases the axial electron velocities, thus, increasing the actual pitch factor value in the cavity up to 1.4. As a result of this effect, high power and high efficiency cannot be obtained simultaneously in a low-voltage gyrotron. Using particle-in-cell simulations, two variants of low-voltage (5 kV) gyrotrons have been designed, namely, a device with higher power and an optimal pitch factor of 0.82 in the cavity and a device with a high pitch factor and high efficiency, but lower power.