Finale: 22.08.2004
| Medaille | Sportler | Nation |
| Gold | Mizuki Noguchi | Japan |
| Silber | Catherine Ndereba | Kenia |
| Bronze | Deena Kastor | USA |
| Rang | Sportler | Nation | Stunden |
| 1 | Mizuki Noguchi | Japan | 2:26:20 |
| 2 | Catherine Ndereba | Kenia | 2:26:32 |
| 3 | Deena Kastor | USA | 2:27:20 |
| 4 | Elfenesh Alemu | Äthiopien | 2:28:15 |
| 5 | Reiko Tosa | Japan | 2:28:44 |
| 6 | Olivera Jevtic | Serbien und Montenegro | 2:31:15 |
| 7 | Naoko Sakamoto | Japan | 2:31:43 |
| 8 | Ludmilla Petrowa | Russland | 2:31:56 |