| Final Ranking | time | | gap pen. | | 1. Kimberly García |  Peru | 2:39:16 | CR, AR, NR | | | 2. Katarzyna Zdziebło |  Poland | 2:40:03 | PB | +0:47 > | | 3. Qieyang Shijie |  China | 2:40:37 | AR, NR, PB | +1:21 | | 4. Antigoni Drisbioti |  Greece | 2:41:58 | NR, PB | +2:42 | | 5. Raquel González |  Spain | 2:42:27 | PB | +3:11 ~ | | 6. Laura García-Caro | Spain | 2:42:45 | PB | +3:29 | | 7. Li Maocuo | China | 2:44:28 | PB | +5:12 | | 8. Viviane Lyra |  Brazil | 2:45:02 | NR | +5:46 ~ | | 9. Serena Sonoda |  Japan | 2:45:09 | PB | +5:53 | | 10.Yin Lamei | China | 2:46:02 | PB | +6:46 > | | 11.Olga Niedziałek | Poland | 2:49:43 | PB | +10:27 ~ | | 12.Magaly Bonilla |  Ecuador | 2:50:39 | | +11:23 ~~ | | 13.Inês Henriques |  Portugal | 2:51:12 | SB | +11:56 ~~ | | 14.Nadia González |  Mexico | 2:52:06 | NR, PB | +12:50 | | 15.Mirna Ortíz |  Guatemala | 2:54:00 | | +14:44 ~ | | 16.Paola Pérez | Ecuador | 2:54:15 | | +14:59 | | 17.Galina Yakusheva |  Kazakhstan | 2:54:50 | PB | +15:34 | | 18.Evelyn Inga | Peru | 2:56:04 | | +16:48 > | | 19.Vitória Oliveira | Portugal | 2:57:37 | | +18:21 | | 20.Elisa Neuvonen |  Finland | 2:57:42 | NR, PB | +18:26 | | 21.Alejandra Ortega | Mexico | 2:58:46 | | +19:30 > | | 22.Maria Michta-Coffey |  United States | 2:58:51 | PB | +19:35 | | 23.Hana Burzalová |  Slovakia | 2:59:32 | NR, PB | +20:16 | | 24.Stephanie Casey | United States | 3:00:54 | PB | +21:38 > | | 25.Yasury Palacios | Guatemala | 3:01:16 | | +22:00 ~ | | 26.Ana Veronica Rodean |  Romania | 3:01:29 | SB | +22:13 | | 27.Efstathia Kourkoutsaki | Greece | 3:02:27 | PB | +23:11 | | 28.Aura Morales | Mexico | 3:04:50 | | +25:34 >> | | 29.Miranda Melville | United States | 3:05:31 | | +26:15 >> | | 30.Elianay Pereira | Brazil | 3:05:39 | PB | +26:23 | | 31.Mayara Luize Vicentainer | Brazil | 3:06:10 | | +26:54 | | 32.Ema Hačundová | Slovakia | 3:07:02 | PB | +27:46 | | 33.Jaaneth Mamani |  Bolivia | 3:07:16 | PB | +28:00 >> | | 34.Kelly Ruddick |  Australia | 3:11:55 | | +32:39 | | 35.Sandra Silva | Portugal | 3:17:23 | PB | +38:07 > | | -. Tereza Ďurdiaková |  Czechia | DNF | | - > | | -. Christina Papadopoulou | Greece | DNF | | - | | -. Mihaela Acatrinei | Romania | DNF | | - ~ | | -. Nadiya Borovska |  Ukraine | DNF | PZ210 | - ~>> | | -. Tiia Kuikka | Finland | DQ | TR54.7.5 | - >>>> | | -. Polina Repina | Kazakhstan | DQ | TR54.7.5 | - >>>> |
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| | | Venue; 1 kilometer loop on Martin Luther King Jr. Boulevard. | | Start: 06:15 Temperature: 14° C Humidity: 85% | | End: 09:19 Temperature: 14° C Humidity: 85% | | 43 Competitors from 20 Nations. Quota ---. | | Entry Standard: 2:54.00 or 50km: 4:25:00. |
| Intermediate Times: | | 5km: Katarzyna Zdziebło (POL) 23:26 | | 10km: Kimberly García (PER) 46:27 | | 15km: Kimberly García (PER) 1:09:25 | | 20km: Kimberly García (PER) 1:31:49 | | 25km: Kimberly García (PER) 1:54:33 | | 30km: Kimberly García (PER) 2:17.05 |
| World record: world records will be recognised after 1 January 2023 | | Championship record: new event | | World Leading: Margarita Nikiforova, Russia 2:38:49 Cheboksary, Russia 21 May 2022 | | African Record: Esther Steenkamp, South Africa 3:42:04 Cape Town, South Africa 15 January 2022 | | Asian Record: Qieyang Shijie, China 2:43:06 Dudince, Slovakia 23 April 2022 | | North, Central American and Caribbean Record: Robyn Stevens, United States 2:49:29 Dudince, Slovakia 23 April 2022 | | South American Record: Kimberly García, Peru 2:43:19 Dudince, Slovakia 23 April 2022 | | European Record: María Pérez, Spain 2:39:16 Lepe, Spain 30 January 2022 | | Oceanian record: No ratified record |
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