| Final 20:30 | time | | | 1. China |  CHN | 3:31.37 | GR | | Xu Jiayu | 53.18s | | | Li Xiang | 59.84s | | | Li Zhuhao | 51.44s | | | Ning Zetao | 46.91s | | | 2. Japan |  JPN | 3:31.70 | | Ryosuke Irie | 52.45s | | | Yasuhiro Koseki | 59.03s | | | Hirofumi Ikebata | 52.12s | | | Shinri Shioura | 48.10s | | | 2. Uzbekistan |  UZB | 3:43.54 | | Daniil Bukin | 57.83s | | | Vladislav Mustafin | 1:01.51 | | | Islam Aslanov | 54.67s | | | Khurshidjon Tursunov | 49.53s | | | 4. Indonesia |  INA | 3:43.81 | | I Gede Siman Sudartawa | 56.05s | | | Dennis Josua Tiwa | 1:03.57 | | | Glenn Victor Sutanto | 53.65s | | | Triady Fauzi Sidiq | 50.54s | | | 5. Singapore |  SGP | 3:44.17 | | Rainer Ng | 57.62s | | | Christopher Cheong | 1:03.36 | | | Joseph Schooling | 53.75s | | | Clement Lim | 49.44s | | | 6. Chinese Taipei |  TPE | 3:44.77 | | Lin Shih-chieh | 57.52s | | | Lee Hsuan-yen | 1:03.31 | | | Hsu Chi-chieh | 54.09s | | | Wang Yu-lian | 49.85s | | | 7. Hong Kong |  HKG | 3:44.83 | | Lau Shiu Yue | 57.61s | | | Ronald Tsui | 1:03.32 | | | Geoffrey Cheah | 53.63s | | | Jeremy Wong | 50.27s | | | DQ. South Korea |  KOR | 3:39.18 | | Park Seon-kwan | 54.80s | | | Choi Kyu-woong | 1:01.13 | | | Chang Gyu-cheol | 53.44s | | | Park Tae-hwan | 49.81s | |
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| Venue: Muhak Park Tae-hwan Aquatics Center. | | South Korea originally won the bronze medal, but was later disqualified after Park Tae-hwan tested positive for Nebido. |
| World record: United States 3:27.28 Rome, Italy 2 August 2009 | | Asian record: Japan 3:30.74 Rome, Italy 2 August 2009 | | Games record: Japan 3:34.10 Guangzhou, China 18 November 2010 |
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