See main article: Swimming at the 2010 South American Games. The Men's 400m individual medley event at the 2010 South American Games was held on March 29, with the heats at 11:02 and the Final at 18:25.
| width=200 bgcolor=gold | Gold | width=200 bgcolor=silver | Silver | width=200 bgcolor=CC9966 | Bronze |
| Thiago Pereira | Esteban Enderica | Cristhian Orjuela |
| Standing records prior to the 2010 South American Games | |||||
|---|---|---|---|---|---|
| World record | 4:03.84 | Beijing, China | 10 August 2008 | ||
| Competition Record | 4:31.91 | Buenos Aires, Argentina | 18 November 2006 | ||
| South American record | 4:08.86 | Rome, Italy | 2 August 2009 | ||
| Rank | Heat | Lane | width=250 | Athlete ! | width=100 | Result ! | Notes |
|---|---|---|---|---|---|---|---|
| 1 | 3 | 4 | 4:36.48 | Q | |||
| 2 | 1 | 3 | 4:38.92 | Q | |||
| 3 | 2 | 3 | 4:39.74 | Q | |||
| 4 | 3 | 6 | 4:42.12 | Q | |||
| 5 | 3 | 3 | 4:42.40 | Q | |||
| 6 | 2 | 5 | 4:43.56 | Q | |||
| 7 | 1 | 6 | 4:45.40 | Q | |||
| 8 | 1 | 5 | 4:45.46 | Q | |||
| 9 | 2 | 6 | 4:46.41 | ||||
| 10 | 3 | 2 | 4:58.17 | ||||
| 11 | 3 | 5 | 5:00.56 | ||||
| 12 | 1 | 2 | 5:23.39 | ||||
| 1 | 4 | DNS | |||||
| 2 | 2 | DNS | |||||
| 2 | 4 | DNS | |||||
| 2 | 7 | DNS | |||||
| 3 | 7 | DNS | |||||
| Rank | Lane | width=250 | Athlete ! | width=100 | Result ! | Notes |
|---|---|---|---|---|---|---|
| 4 | 4:28.79 | CR | ||||
| 2 | 4:30.41 | |||||
| 5 | 4:35.24 | |||||
| 4 | 3 | 4:38.76 | ||||
| 5 | 8 | 4:45.00 | ||||
| 6 | 7 | 4:45.06 | ||||
| 7 | 6 | 4:45.11 | ||||
| 8 | 1 | 4:56.56 | ||||