A panel of experts mandated by the UN's Human Rights Council said North Koreans had suffered "unspeakable atrocities".
The panel heard evidence of torture, enslavement, sexual violence, severe political repression and other crimes.
North Korea has rejected the report's conclusions.
The UN commission said leader Kim Jong-un had refused to respond to an advance copy of the report, which warned him he could be held responsible for abuses.
"It is a report which speaks of the great wrongs that have been done to the people of North Korea and calls for attention from the international community," said Michael Kirby, chairman of the independent Commission of Inquiry, as he launched the report in Geneva.
The findings recommend an inquiry be launched by an international court or tribunal.
"The suffering and tears of the people of North Korea demand action, and that is the proposal," said Mr Kirby.
Testimony to the panel included an account of a woman forced to drown her own baby, children imprisoned from birth and starved, and families tortured for watching a foreign soap opera.
The full report contains hundreds of pages of further evidence of a nationwide policy of control through terror.
"In many instances, the violations of human rights found by the commission constitute crimes against humanity," said the report.
"These are not mere excesses of the state; they are essential components of a political system that has moved far from the ideals on which it claims to be founded."
The BBC's Imogen Foulkes in Geneva says the report is one of the most detailed and devastating ever published by the United Nations.
North Korea "categorically and totally rejects" the report into its human rights record, it said in a two-page statement sent to Reuters from its diplomatic mission in Geneva.
"The DPRK [North Korea] once again makes it clear that the 'human rights violations' mentioned in the so-called 'report' do not exist in our country."
Credit to BBC
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