US District Judge Lewis Kaplan in Manhattan ordered the disbursement of nearly $US5.8 million ($A8.4 million) to the former Elle magazine advice columnist, representing the original $US5 million ($A7.2 million) verdict plus interest.
The funds had been held while Trump appealed the verdict, but the US Supreme Court on June 29 declined to take up the Republican president's case. None of the nine justices, including three appointed by Trump, noted dissents.
Kaplan said Carroll was entitled to the money now, more than six-and-a-half years after she first sued Trump in 2019.
"Defendant has been stalling this case for years," the judge wrote. "It is time for him to 'do equity' and pay the judgment."
Trump asked the federal appeals court in Manhattan to put the disbursement on immediate hold while he appealed.
The court denied his motion. Trump's lawyers did not immediately respond to requests for comment on the president's next legal steps.
"The American People stand with President Trump as they demand an immediate end to all of the Witch Hunts, including the Democrat-funded travesty of the Carroll Hoaxes," a spokesperson for Trump's lawyers said in a statement following Kaplan's order.
In a filing opposing the appeal, Carroll's lawyers called it Trump's latest effort to drag out proceedings, file meritless appeals, and raise new defences when old defences fail.
"Defendant is out of time," Carroll's lawyers said. "Carroll has waited more than three years for a jury's verdict to be paid. She should not have to wait any longer."
Carroll's lawyers have said their 82-year-old client intends to put the money in an interest-bearing account and use it to fund her retirement.
Carroll accused Trump, 80, of raping her around 1996 in a Bergdorf Goodman department store dressing room in Manhattan.
Trump has rejected Carroll's claims as a hoax and "con job", denying he knew her and saying she made up the alleged rape to help sell her memoir.
Jurors awarded Carroll $US5 million ($A7.2 million) based on a Trump denial in 2022, though they did not find that Trump raped her.
A different jury in 2024 ordered Trump to pay Carroll $US83.3 million ($A120 million) in damages based on his original denial in 2019, which occurred during his first White House term.
Trump has said he deserves presidential immunity for that denial. Last September, the federal appeals court in Manhattan declined to throw out the $US83.3 million verdict.
Trump plans to appeal that decision to the Supreme Court, and his lawyers said a successful appeal could undermine the basis for the $US5 million verdict.
