Garefrekes made her debut for German national team in November 2001 in against the Netherlands. Two years later, she won her first major international title at the 2003 FIFA Women's World Cup. She was an important player for the team, starting in five of the team's six matches and scoring four goals. Garefrekes scored Germany's first and ultimately decisive goal in the semi-final win over the United States. She went on to win the bronze medal at the 2004 Summer Olympics and the title at the 2005 European Championship. In qualifying for the UEFA Women's Euro 2009, she scored a number of goals, including a hat-trick in Germany's 7–0 defeat of Switzerland.