The women's 4 × 400 metres relay event at the 2019 Summer Universiade was held on 12 and 13 July at the Stadio San Paolo in Naples.
| width=200 valign=top | Mariia Mykolenko Anastasiia Holienieva Kateryna Klymiuk Tetiana Melnyk | width=200 valign=top | Frida Corona Dania Aguillón Rosa Cook Paola Morán | width=200 valign=top | Genevieve Cowie Morgan Mitchell Jessie Stafford Gabriella O'Grady |
Qualification: First 3 teams in each heat (Q) and the next 2 fastest (q) qualified for the final.[1]
| Rank | Heat | Nation | Athletes | Time | Notes | |
|---|---|---|---|---|---|---|
| 1 | 1 | 3:33.24 | Q | |||
| 2 | 2 | 3:34.02 | Q | |||
| 3 | 2 | 3:34.22 | Q | |||
| 4 | 2 | 3:34.51 | Q | |||
| 5 | 1 | 3:34.67 | Q | |||
| 6 | 2 | 3:34.83 | q | |||
| 7 | 1 | 3:36.12 | Q | |||
| 8 | 2 | 3:36.37 | q | |||
| 9 | 2 | 3:37.94 | ||||
| 10 | 1 | 3:39.67 | ||||
| 11 | 1 | 3:40.00 | ||||
| 12 | 1 | 3:58.07 | ||||
| 1 | R170.19[2] | |||||
| 1 | ||||||
| 2 | ||||||
| 2 |
| Rank | Nation | Athletes | Time | Notes | |
|---|---|---|---|---|---|
| 3:30.82 | |||||
| 3:32.63 | |||||
| 3:34.01 | |||||
| 4 | 3:34.04 | ||||
| 5 | 3:34.62 | ||||
| 6 | 3:34.66 | ||||
| 7 | 3:35.97 | ||||