Synchronized swimming at the 2003 Pan American Games was held from August 1 to August 17, 2003 in Santo Domingo, Dominican Republic. There were just two medal events after the exclusion of the solo event.
| Duet | Alison Bartosik Anna Kozlova | Fanny Létourneau Courtenay Stewart | Carolina Moraes Isabela Moraes | |
| Team |
| Rank | Synchronized swimmers | Total points | |
|---|---|---|---|
| 95.917 | |||
| 95.584 | |||
| 91.833 | |||
| 4 | 87.834 | ||
| 5 | 84.000 | ||
| 6 | 82.833 | ||
| 7 | 80.084 | ||
| 8 | 73.084 | ||
| 9 | 73.000 | ||
| 10 | 69.334 |
| Rank | Nation | Total points | |
|---|---|---|---|
| 97.000 | |||
| 96.416 | |||
| 91.166 | |||
| 4 | 88.250 | ||
| 5 | 84.500 | ||
| 6 | 81.250 | ||
| 7 | 68.250 |