Women's water polo is a relatively recent addition to the program of the Olympic Games, making its debut in 2000. Although technical and tactical aspects of men's water polo performance have been studied, there is a paucity of information on the women's competition. Thus, the present study aimed to analyze the technical and tactical aspects of 12 National Collegiate Athletic Association (NCAA) women's water polo matches in relation to 3 playing situations (Even, Counterattack, Power Play) and match outcome (winning and losing teams). The notational analysis included the following indicators: frequency of occurrence of the offensive actions, duration, players, passes, turnovers, exclusion and penalty achievement, goal, and origin and type of shot. Differences between winning and losing teams emerged for duration of actions (p = 0.024), number of players (p = 0.033), passes (p < 0.0001), exclusions and penalties achieved (p = 0.026), shots originating inside (p = 0.002) and outside (p = 0.002) the 5-m area, and occurrence of goals (p < 0.0001) during the Even situation; exclusions and penalties achieved (p = 0.029), shots following up fake (p = 0.049), and goals (p = 0.021) during the Counterattacks; and passes (p = 0.02), and goals (p = 0.003) during the Power-Play actions. In conclusion, winners showed a better ability to perform faster actions, with more effective passes leading to goals. Thus, women's water polo NCAA coaches and conditioners are encouraged to evaluate the studied technical and tactical parameters when analyzing game performances of their teams.