These are the results from the synchronised swimming competition at the 1991 World Aquatics Championships. The United States was the top achiever in the 1991 world championship, winning two gold medas and 1 silver.
| width=150 | Event | width=250 bgcolor=gold | Gold | width=250 bgcolor=silver | Silver | width=250 bgcolor=CC9966 | Bronze |
| Solo routine | 201.013 | 196.314 | 195.110 | ||||
| Duet routine | 199.762 | 194.307 | 192.649 | ||||
| Team routine | Kristen Babb-Sprague Becky Dyroen Karen Josephson Sarah Josephson Jill Savery Nathalie Schneyder Heather Simmons Michelle Svitenko 196.144 | Lisa Alexander Karen Clark Charlene Davies Karen Fonteyne Kathy Glen Heather Johnston Christine Larsen Cari Read 193.259 | Hisako Aoishi Mina Enkaku Kiyoko Ishibashi Ikuko Kato Fumiko Okuno Aki Takayama Yumi Wakabayashi Chiaki Yamamura 189.753 |