The United States team was forced to wait four long years for their rematch against Canada on hockey's grandest stage. In 2014 the Americans let a 2-0 lead slip away in the third period and lost the gold medal game in overtime. The 2018 gold medal game would be every bit as dramatic.

Both the American and Canadian teams won their respective semi-final games by 5-0 scores, setting up the sixth consecutive gold medal contest.

With gold on the line, Hilary Knight would open the scoring late in the first period, giving the Americans the lead at the break. Canada would bounce back in the second period, with Haley Irwin and Marie-Philip Poulin finding the back of the net. Canada's 2-1 lead would hold up until 13:39 of the third period when Monique Lamoureux evened the score.

For the second straight Olympic Games 60 minutes was not enough to determine a champion and overtime was needed. The teams exchanged chances, but remained deadlocked after 20 minutes of extra time. For the first time in Women's Olympic Hockey history, the gold medal-winner would be determined by shootout. The shootout too would go an extra round with Jocelyne Lamoureux scoring the eventual winner with a dazzling deke.

The gold medal victory was the first for the United States in two decades and another legendary chapter in one of hockey's greatest rivalries.

Finland would defeat the Olympic Athletes from Russia for the bronze and goaltender Shannon Szabados of Canada, Finnish defender Jenni Hiirikoski and Swiss forward Alina Muller were named the tournament's best players as selected by the directorate.