# Swimming at the 2023 World Aquatics Championships – Women's 4 × 100 metre medley relay

The women's 4 × 100 metre medley relay competition at the 2023 World Aquatics Championships was held on 30 July 2023.

## Records

Prior to the competition, the existing world and championship records were as follows.
| World record | United States Regan Smith (57.57) Lilly King (1:04.81) Kelsi Dahlia (56.16) Simone Manuel (51.86) | 3:50.40 | Gwangju, South Korea | 28 July 2019 |
| Competition record | United States Regan Smith (57.57) Lilly King (1:04.81) Kelsi Dahlia (56.16) Simone Manuel (51.86) | 3:50.40 | Gwangju, South Korea | 28 July 2019 |

## Results
### Heats

The heats were held at 11:14.
| Rank | Heat | Lane | Nation | Swimmers | Time | Notes |
| 1 | 3 | 5 | Canada | Ingrid Wilm (59.11) Sophie Angus (1:06.30) Maggie Mac Neil (56.53) Mary-Sophie Harvey (53.99) | 3:55.93 | Q |
| 2 | 3 | 4 | United States | Katharine Berkoff (58.56) Lydia Jacoby (1:07.73) Torri Huske (57.42) Abbey Weitzeil (52.60) | 3:56.31 | Q |
| 3 | 2 | 5 | Sweden | Michelle Coleman (1:01.51) Sophie Hansson (1:06.67) Louise Hansson (56.90) Sarah Sjöström (52.41) | 3:57.49 | Q |
| 4 | 2 | 4 | Australia | Madison Wilson (59.54) Abbey Harkin (1:07.66) Brianna Throssell (57.72) Meg Harris (52.82) | 3:57.74 | Q |
| 5 | 2 | 3 | Netherlands | Kira Toussaint (1:00.57) Tes Schouten (1:06.79) Kim Busch (58.46) Marrit Steenbergen (51.99) | 3:57.81 | Q |
| 6 | 2 | 6 | China | Wang Xueer (1:00.42) Yang Chang (1:07.12) Wang Yichun (57.17) Wu Qingfeng (53.42) | 3:58.13 | Q |
| 7 | 3 | 3 | France | Pauline Mahieu (59.82) Charlotte Bonnet (1:06.87) Marie Wattel (57.08) Lison Nowaczyk (54.77) | 3:58.54 | Q |
| 8 | 2 | 7 | Japan | Rio Shirai (1:00.60) Reona Aoki (1:06.57) Ai Soma (57.48) Rikako Ikee (53.93) | 3:58.58 | Q |
| 9 | 3 | 2 | Great Britain | Lauren Cox (59.79) Kara Hanlon (1:07.39) Laura Stephens (58.66) Anna Hopkin (53.11) | 3:58.95 | |
| 10 | 2 | 2 | Poland | Adela Piskorska (1:00.47) Dominika Sztandera (1:07.01) Paulina Peda (58.57) Kornelia Fiedkiewicz (54.18) | 4:00.23 | NR |
| 11 | 3 | 6 | Italy | Margherita Panziera (1:00.60) Martina Carraro (1:06.39) Ilaria Bianchi (59.08) Sofia Morini (54.60) | 4:00.67 | |
| 12 | 3 | 8 | Germany | Laura Riedemann (1:01.68) Anna Elendt (1:07.23) Angelina Köhler (56.77) Nele Schulze (55.03) | 4:00.71 | |
| 13 | 3 | 9 | Ireland | Danielle Hill (1:01.65) Mona McSharry (1:05.55) Ellen Walshe (59.19) Victoria Catterson (54.86) | 4:01.25 | NR |
| 14 | 2 | 0 | Denmark | Julie Kepp Jensen (1:03.33) Thea Blomsterberg (1:06.92) Helena Rosendahl Bach (58.51) Signe Bro (54.57) | 4:03.33 | |
| 15 | 1 | 6 | Belgium | Roos Vanotterdijk (1:00.91) Florine Gaspard (1:09.14) Valentine Dumont (59.09) Fleur Verdonck (55.40) | 4:04.54 | NR |
| 16 | 1 | 3 | Hong Kong | Stephanie Au (1:00.75) Siobhán Haughey (1:07.49) Tam Hoi Lam (1:00.96) Camille Cheng (55.69) | 4:04.89 | |
| 17 | 1 | 4 | Greece | Theodora Drakou (1:00.71 NR) Eleni Kontogeorgou (1:10.23) Anna Ntountounaki (58.26) Maria-Thalia Drasidou (55.79) | 4:04.99 | |
| 18 | 2 | 1 | South Korea | Lee Eun-ji (1:01.31) Kwon Se-hyun (1:09.94) Kim Seo-yeong (59.74) Hur Yeon-kyung (54.17) | 4:05.16 | |
| 19 | 3 | 7 | Israel | Aviv Barzelay (1:02.13) Anastasia Gorbenko (1:06.94) Lea Polonsky (1:00.48) Daria Golovaty (56.02) | 4:05.57 | |
| 20 | 3 | 0 | Spain | Carmen Weiler (1:01.46) Jessica Vall (1:08.32) Paula Juste (1:00.27) Ainhoa Campabadal (55.80) | 4:05.85 | |
| 21 | 3 | 1 | Brazil | Julia Góes (1:03.96) Jhennifer Conceição (1:08.48) Giovanna Diamante (59.32) Stephanie Balduccini (54.10) | 4:05.86 | |
| 22 | 1 | 5 | Mexico | Miranda Grana (1:02.11) Melissa Rodríguez (1:08.80) María José Mata (59.54) Athena Meneses (56.40) | 4:06.85 | NR |
| 23 | 2 | 9 | Thailand | Saovanee Boonamphai (1:06.39) Phiangkhwan Pawapotako (1:12.25) Kamonchanok Kwanmuang (1:01.97) Jenjira Srisaard (59.82) | 4:20.43 | |
| | 2 | 8 | Hungary | DNS | DNS | DNS |

### Final

The final was held at 21:37.
| Rank | Lane | Nation | Swimmers | Time |
| | 5 | United States | Regan Smith (57.68) Lilly King (1:04.93) Gretchen Walsh (57.06) Kate Douglass (52.41) | 3:52.08 |
| | 6 | Australia | Kaylee McKeown (57.91) Abbey Harkin (1:07.07) Emma McKeon (56.44) Mollie O'Callaghan (51.95) | 3:53.37 |
| | 4 | Canada | Kylie Masse (58.74) Sophie Angus (1:06.21) Maggie Mac Neil (55.69) Summer McIntosh (53.48) | 3:54.12 |
| 4 | 7 | China | Wan Letian (59.49) Tang Qianting (1:06.13) Zhang Yufei (55.50) Cheng Yujie (53.45) | 3:54.57 |
| 5 | 3 | Sweden | Michelle Coleman (1:01.08) Sophie Hansson (1:06.34) Louise Hansson (56.82) Sarah Sjöström (52.08) | 3:56.32 |
| 6 | 8 | Japan | Rio Shirai (1:00.96) Satomi Suzuki (1:05.73) Ai Soma (57.67) Rikako Ikee (53.66) | 3:58.02 |
| 7 | 2 | Netherlands | Kira Toussaint (1:00.34) Tes Schouten (1:06.91) Kim Busch (58.88) Marrit Steenbergen (51.96) | 3:58.09 |
| 8 | 1 | France | Pauline Mahieu (1:00.12) Charlotte Bonnet (1:06.78) Marie Wattel (57.72) Lison Nowaczyk (54.62) | 3:59.24 |