1 | People's Republic of China | CHN | 3:56.78 (1 h1) | 3:52.52 (1) | Gold | | |
| Bai Anqi • He Jianbin • Liu Lan • Sun Bowei • Tang Yi • Wang Ximing |
2 | Russian Federation | RUS | 4:00.67 (1 h2) | 3:55.29 (2) | Silver | | |
| Yekaterina Andreyeva • Aleksey Atsapkin • Kristina Kochetkova • Ilya Lemayev • Anton Lobanov • Aleksandra Papusha • Andrey Ushakov |
3 | Australia | AUS | 3:59.14 (1 h3) | 3:55.63 (3) | Bronze | | |
| Max Ackermann • Justin James • Zoe Johnson • Emma McKeon • Nick Schafer • Emily Selig • Kenneth To • Madi Wilson |
4 | France | FRA | 4:00.82 (2 h2) | 3:56.64 (4) | | | |
| Mathilde Cini • Jordan Coelho • Marie Jugnet • Thomas Rabeisen • Mehdy Metella |
5 | Canada | CAN | 4:02.69 (3 h2) | 4:02.22 (5) | | | |
| Jeremy Bagshaw • Chad Bobrosky • Lindsay Delmar • Tera Van Beilen • Rachel Nicol |
6 | United States | USA | 4:04.29 (4 h2) | 4:02.90 (6) | | | |
| Kaitlyn Jones • Jordan Mattern • Erich Peske • Austin Ringquist |
7 | Japan | JPN | 4:06.13 (3 h3) | 4:06.18 (7) | | | |
| Mayuko Okada • Tatsunari Shoda • Takahiro Tsutsumi • Yukiko Watanabe |
8 | Germany | GER | 4:02.56 (2 h3) | – (DQ) | | | |
| Christian Diener • Lena Kalla • Kevin Leithold • Lina Rathsack |
9 | South Africa | RSA | 4:06.14 (5 h2) | – | | | |
| Dylan Bosch • Oneida Cooper • Chad le Clos • Kyla Ferreira |
10 | Spain | ESP | 4:07.05 (2 h1) | – | | | |
| Teresa Gutiérrez • Judit Ignacio • Adrián Mantas • Aitor Martínez |
11 | Brazil | BRA | 4:08.25 (4 h3) | – | | | |
| Vinícius Borges • Pedro Costa • Bruna Rocha • Júlia Gerotto |
12 | Singapore | SGP | 4:08.94 (5 h3) | – | | | |
| Rainer Ng • Cheryl Lim • Pang Sheng Jun • Adeline Winata |
13 | Hong Kong, China | HKG | 4:14.66 (3 h1) | – | | | |
| Kent Cheung • Yvette Kong • Jeffrey Lum • Yu Wai Ting |
14 | Iceland | ISL | 4:18.81 (6 h2) | – | | | |
| Bryndís Hansen • Ingibjörg Jónsdóttir • Anton McKee • Hrafn Traustason |
15 | Trinidad and Tobago | TTO | 4:20.21 (6 h3) | – | | | |
| Christian Homer • Kimberlee John-Williams • Cadell Lyons • Khadeja Phillip |
16 | Serbia | SRB | 4:21.02 (4 h1) | – | | | |
| Stefan Šorak • Marija Joksimović • Katarina Simonović • Velimir Stjepanović |
DNS | Italy | ITA | – (DNS h1) | – | | | |
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