| Final 19:52 | | time | | gap | L | | 1. |  United States | 3:38.79 | | | 4 | | | Hunter Armstrong 52.14s, Nic Fink 57.86s, Torri Huske 56.17s, Claire Curzan 52.62s | | 2. |  Australia | 3:41.34 | | | 6 | | | Kaylee McKeown 58.66s, Zac Stubblety-Cook 58.92s, Matthew Temple 50.84s, Shayna Jack 52.92s | | 3. |  Netherlands | 3:41.54 | | | 5 | | | Kira Toussaint 59.72s, Arno Kamminga 58.28s, Nyls Korstanje 50.99s, Marrit Steenbergen 52.55s | | 4. |  Great Britain | 3:41.65 | | | 3 | | | Medi Harris 59.51s, James Wilby 58.49s, James Guy 50.95s, Freya Anderson 52.70s | | 5. |  Italy | 3:41.67 | | | 1 | | | Thomas Ceccon 52.26s, Nicolò Martinenghi 57.93s, Elena Di Liddo 57.72s, Silvia Di Pietro 53.76s | | 6. |  China | 3:43.55 | | | 2 | | | Xu Jiayu 52.90s, Yan Zibei 59.25s, Zhang Yufei 57.74s, Cheng Yujie 53.66s | | 7. |  Japan | 3:45.28 | | | 7 | | | Ryosuke Irie 52.97s, Reona Aoki 1:07.10, Naoki Mizunuma 50.89s, Rika Omoto 54.32s | | 8. |  Germany | 3:46.64 | | | 8 | | | Ole Braunschweig 54.08s, Anna Elendt 1:05.83, Angelina Köhler 58.39s, Rafael Miroslaw 48.34s |
| 140 Competitors from 31 Nations. | | World Record: Great Britaon 3:37.58 Tokyo, Japan 31st July 2021 | | World Championship Record: United States 3:38.56 Budapest, Hungary 2017 |
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Heats - Tuesday, 21st June 2022 10:13 | | Best 8 times advanced to Final. |
| Heat 4 | | time | | gap | L | Rk. | | 1. | Australia | 3:25.55 | Q | | 0 | 3. | | | Zac Incerti 49.28s, William Yang 48.39s, Meg Harris 53.97s, Leah Neale 53.91s | | 2. | Italy | 3:26.00 | Q | | 5 | 5. | | | Leonardo Deplano 48.92s, Alessandro Miressi 48.16s, Silvia Di Pietro 54.62s, Chiara Tarantino 54.30s | | 3. | Great Britain | 3:26.10 | Q | | 4 | 6. | | | Jacob Whittle 49.04s, Matt Richards 48.57s, Freya Anderson 54.03s, Lucy Hope 54.46s | | 4. |  Brazil | 3:26.31 | Q | | 3 | 7. | | | Vinicius Assunção 48.95s, Gabriel Santos 48.70s, Stephanie Balduccini 54.29s, Giovanna Diamante 54.37s | | 5. | China | 3:27.20 | Q | | 1 | 8. | | | Hong Jinquan 49.26s, Wang Changhao 49.20s, Lao Lihui 54.40s, Ai Yanhan 54.34s | | 6. |  South Korea | 3:29.35 | | | 8 | 11. | | | Hwang Sun-woo 49.18s, Lee Yoo-yeon 49.64s, Jeong So-eun 55.42s, Hur Yeon-kyung 55.11s | | 7. |  Hong Kong | 3:35.26 | | | 9 | 16. | | | Ian Ho 50.12s, Nicholas Lim 51.30s, Camille Cheng 56.67s, Chloe Cheng 57.17s | | 8. |  Morocco | 3:43.33 | | | 2 | 18. | | | Samy Boutouil 50.42s, Souhail Hamouchane 52.76s, Lina Khiyara 1:00.53, Imane El Barodi 59.62s | | -. |  Tanzania | DSQ | | | 7 | -. | | | Dennis Mhini 59.10s, Eunike Fugo 1:15.13, Kayla Temba 1:23.02, Collins Saliboko | | -. |  Angola | DNS | | | 6 | -. | | | |
| Heat 3 | | time | | gap | L | Rk. | | 1. | Australia | 3:25.55 | Q | | 0 | 3. | | | Zac Incerti 49.28s, William Yang 48.39s, Meg Harris 53.97s, Leah Neale 53.91s | | 2. | Italy | 3:26.00 | Q | | 5 | 5. | | | Leonardo Deplano 48.92s, Alessandro Miressi 48.16s, Silvia Di Pietro 54.62s, Chiara Tarantino 54.30s | | 3. | Great Britain | 3:26.10 | Q | | 4 | 6. | | | Jacob Whittle 49.04s, Matt Richards 48.57s, Freya Anderson 54.03s, Lucy Hope 54.46s | | 4. | Brazil | 3:26.31 | Q | | 3 | 7. | | | Vinicius Assunção 48.95s, Gabriel Santos 48.70s, Stephanie Balduccini 54.29s, Giovanna Diamante 54.37s | | 5. | China | 3:27.20 | Q | | 1 | 8. | | | Hong Jinquan 49.26s, Wang Changhao 49.20s, Lao Lihui 54.40s, Ai Yanhan 54.34s | | 6. | South Korea | 3:29.35 | | | 8 | 11. | | | Hwang Sun-woo 49.18s, Lee Yoo-yeon 49.64s, Jeong So-eun 55.42s, Hur Yeon-kyung 55.11s | | 7. | Hong Kong | 3:35.26 | | | 9 | 16. | | | Ian Ho 50.12s, Nicholas Lim 51.30s, Camille Cheng 56.67s, Chloe Cheng 57.17s | | 8. | Morocco | 3:43.33 | | | 2 | 18. | | | Samy Boutouil 50.42s, Souhail Hamouchane 52.76s, Lina Khiyara 1:00.53, Imane El Barodi 59.62s | | -. | Tanzania | DSQ | | | 7 | -. | | | Dennis Mhini 59.10s, Eunike Fugo 1:15.13, Kayla Temba 1:23.02, Collins Saliboko | | -. | Angola | DNS | | | 6 | -. | | | |
| Heat 2 | | time | | gap | L | Rk. | | 1. | United States | 3:24.48 | Q | | 0 | 1. | | | Ryan Held 47.85s, Drew Kibler 48.26s, Erika Brown 53.73s, Kate Douglass 54.64s | | 2. |  Canada | 3:25.30 | Q | | 9 | 2. | | | Ruslan Gaziev 49.16s, Javier Acevedo 48.34s, Taylor Ruck 53.92s, Maggie Mac Neil 53.88s | | 3. | Netherlands | 3:25.86 | Q | | 4 | 4. | | | Stan Pijnenburg 48.79s, Jesse Puts 48.54s, Tessa Giele 55.47s, Marrit Steenbergen 53.06s | | 4. |  Sweden | 3:29.03 | | | 5 | 10. | | | Robin Hanson 49.31s, Isak Eliasson 48.78s, Sofia Åstedt 55.71s, Sara Junevik 55.23s | | 5. |  Greece | 3:34.41 | | | 3 | 14. | | | Stergios Bilas 49.80s, Odysseus Meladinis 49.30s, Maria Drasidou 58.36s, Anna Ntountounaki 56.95s | | 6. |  Mongolia | 3:53.96 | | | 8 | 22. | | | Batbayaryn Enkhkhüslen 59.59s, Batbayaryn Enkhtamir 52.94s, Enkh-Amgalangiin Ariuntamir 1:04.74, Zandanbal Gunsennorov 56.69s | | 7. |  Uganda | 3:56.04 | | | 2 | 23. | | | Adnan Kabuye 56.00s, Kirabo Namutebi 1:03.73, Tendo Mukalazi 53.16s, Avice Meya 1:03.15 | | 8. |  Maldives | 4:18.44 | | | 1 | 26. | | | Mohamed Aan Hussain 56.96s, Aishath Sausan 1:10.71, Hamna Ahmed 1:13.88, Mubal Azzam Ibrahim 56.89s | | -. |  Bahamas | DNS | | | 6 | -. | | | | | -. |  France | DNS | | | 7 | -. | | | |
| Heat 1 | | time | | gap | L | Rk. | | 1. |  New Zealand | 3:27.91 | NR | | 1 | 9. | | | Lewis Clareburt 49.55s, Carter Swift 48.39s, Chelsey Edwards 55.39s, Laura Littlejohn 54.58s | | 2. |  Israel | 3:30.24 | | | 2 | 12. | | | Tomer Frankel 49.45s, Ron Polonsky 48.92s, Lea Polonsky 56.59s, Daria Golovaty 55.28s | | 3. |  Singapore | 3:33.13 | | | 6 | 13. | | | Jonathan Tan 49.72s, Ardi Mohamed Azman 50.46s, Quah Jing Wen 56.21s, Amanda Lim 56.74s | | 7. |  Chinese Taipei | 3:34.68 | Nr | | 5 | 15. | | | Wang Kuan-hung 50.49s, Wang Hsing-hao 50.08s, Hsu An 57.08s, Huang Mei-chien 57.03s | | 4. |  Latvia | 3:38.23 | | | 7 | 17. | | | Feldbergs 51.95s, Daniils Bobrovs 53.72s, Ieva Maļuka 55.78s, Gabriela Ņikitina 56.78s Ģirts | | 5. |  Thailand | 3:43.33 | | | 8 | 18. | | | Dulyawat Kaewsriyong 51.71s, Navaphat Wongcharoen 51.84s, Jinjutha Pholjamjumrus 58.05s, Jenjira Srisaard 1:01.73 | | 6. |  Vietnam | 3:45.88 | | | 4 | 20. | | | Nguyễn Quang Thuấn 52.06s, Nguyễn Hữu Kim Sơn 52.12s, Võ Thị Mỹ Tiên 1:00.62, Lê Thị Thảo My 1:01.08 | | 7. |  Seychelles | 3:53.25 | | | 3 | 21. | | | Mathieu Bachmann 53.54s, Therese Soukup 1:02.27, Simon Bachmann 53.91s, Khema Elizabeth 1:03.53 | | 8. |  Guam | 4:06.21 | | | 0 | 24. | | | Israel Poppe 56.29s, Mia Lee 1:03.46, Keana Santos 1:09.57, Benjamin Ko 56.89s | | 9. |  Northern Mariana | 4:12.95 | | | 9 | 25. | | | Taiyo Akimaru 57.63s, Maria Batallones 1:06.75, Jinie Thompson 1:10.06, Juhn Tenorio 58.51s |
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