Greece opened and goals were swapped until 3-3. Annika Dries gave USA the edge at 4-4 while Ilektra Psouni lobbed one in from the top for 4-4 by quarter time.
Goals were traded again in the second period with Kelly Rulon (USA) from the deep left; Christina Kotsia (GRE) with her first goal of the championship and Melissa Seidemann with a missile from the top for a 6-5 advantage at the long break.

Alkisti Avramidou had the chance to do great things in the third period, scoring from the wide left and then lining up for a penalty attempt. Sadly for her she sent the shot into the left upright. This seemed to lift USA with captain Courtney Mathewson scoring off a quick pass and on extra for 8-6. Kameryn Craig followed suit with a fighting centre-forward effort at 1:29 to give USA a three-goal margin at the last break.

There was trading of goals again in the final quarter with Greece taking the lead through Christina Tsoukala, with her 16th of the championship. Seidemann from the top and Avramidou with her third brought the match to 10-8. Greece called a timeout and earned an exclusion, which Avramidou converted off the first pass at 2:00.

USA earned an exclusion at 0:53 and went to a timeout as the stadium was filling fast ahead of the gold-medal final. The shot was blocked and Greece went on attack, earning an exclusion with three seconds left. The ball swung left to Avramidou and… she shot and scored at 0:00, sending the match to extra time.
Alexandra Asimaki scooped in the first shot of extra time to give Greece the first lead since halfway through the first quarter. Seidemann was dragged from the water with blood streaming from around her left eye and was taken away for urgent medical treatment and no other goals came in the period.

With the clock running down fast, USA went to a timeout at 1:17 to design a goal-scoring movement. The 20 seconds came and went but the team shuffled right and brought up Mathewson at right-hand catch, scoring at 0:54 for 11-11. Greece lost the ball and USA took a third timeout. The ball was turned over at centre forward and Greece had a last shot at a goal after timeout but the first pass was too slow and extra time was over, sending the match to penalty shootout — the third shootout of the championship, men or women.

USA won the toss and shot first with Mathewson converting and Greek captain Antigoni Roumpesi hitting the left upright. Kelly Rulon scored and Tsoukala had her shot blocked by Elizabeth Armstrong. Maggie Steffens ascored and Avramidou converted. It just needed Lauren Silver to convert and the match was won. She did and Greece, the quiet crowd and pool announcer did not realise the result until 20 seconds later.

Match 42: 16:30, Classification 5-6, GREECE 12 UNITED STATES OF AMERICA 15 in penalty shootout (FT: 10-10. ET: 1-1. Pens: 1-4)
Quarters: 4-4, 1-2, 1-3, 3-1, 1-0, 0-1
Referees: Doriel Terpenka (CAN), Manol Taylan (TUR).
Extra Man: GRE: 4/7 (4/11). USA: 1/5 (1/7).
Pens: GRE: 0/1.

Teams:
GREECE:
Eleni Kouvdou, Christina Tsoukala (1), Vasiliki Diamantopoulou, Ilektra
Psouni (1), Margarita Plevritou, Alkisti Avramidou (5), Alexandra
Asimaki (1), Antigoni Roumpesi (2), Christina Kotsia (1), Triantafyllia
Manolioudaki (1), Eleftheria Plevritou, Alkistis Benekou, Chrysoula
Diamantopoulou. Head Coach: Georgios Morfesis.
UNITED STATES OF
AMERICA: Elizabeth Armstrong, Lauren Silver (1), Melissa Seidemann (2),
Rachel Fattal (1), Caroline Clark (1), Margaret Steffens (2), Courtney
Mathewson (4), Kiley Neushal, Jillian Kraus, Kelly Rulon (2), Annika
Dries (1), Kameryn Craig (1), Tumuaialii Anae. Head Coach: Adam
Krikorian.

FLASH QUOTES:

Elizabeth Armstrong (USA):
"We are really happy with the victory, it has been a disappointing game due to the last-minute goal, but we recovered in extra time. In the penalties, Greece has very good shooters and I just concentrated on where the ball was going, and I blocked them, I am very happy for it. We need to improve for the future."

Courtney Mathewson (USA):
"After the game against Spain, we won the next two games so we are very happy for getting here. In the extra time, they scored first and we were very tired out, but we did it in the end. Elizabeth, the keeper, has been awesome tonight."

Adam Krikorian (USA Head Coach):
"The match is not over until the last minute. I congratulate Greece for not giving up. I´m very proud on how my team has recovered after the first goal in extra time. The penalties are always like flipping a coin, but the goalie made amazing

Christina Tsoukala (GRE):
“It´s great to be here again. Sixth place is
OK; next time it will be better. Today has been a hard match, arriving
to the penalties it had been 50-50. ”

Alexandra Asimaki (GRE):
“I have a bitter-sweet feeling, because in the last World Championship we were on top. Our team is new, so we are satisfied of how we have played. Today we have played against USA, the winner of the last Olympic Games. We fought until the penalties; we were unlucky. We have to work very hard for the next Olympic Games in Rio, because as I said, we are a new team.”