| + | Rank | Lane | Athlete | Time | Diff | |
|---|---|---|---|---|---|---|
| + | 1 | 05 |  YE Shiwen | 4:28.43 | WR | - |
| + | 2 | 04 |  BEISEL Elizabeth | 4:31.27 | | +2.84 |
| + | 3 | 06 | LI Xuanxu | 4:32.91 | | +4.48 |
| + | 4 | 03 |  HOSSZU Katinka | 4:33.49 | | +5.06 |
| + | 5 | 07 |  MILEY Hannah | 4:34.17 | | +5.74 |
| + | =6 | 01 |  RICE Stephanie | 4:35.49 | | +7.06 |
| + | =6 | 08 | LEVERENZ Caitlin | 4:35.49 | | +7.06 |
| + | 8 | 02 |  BELMONTE GARCIA Mireia | 4:35.62 | | +7.19 |
