The 24-year-old Hsieh, ranked seventh in the world, defeated Anna Maksymenko of Ukraine in the final.
Despite falling behind 0-2 early on, the World Cup bronze medallist found herself locked in a tightly-contested battle with her opponent before drawing level at 8 apiece within the legal time.
Hsieh held her nerve in the final moments to clinch the decider by the narrowest of margins, winning 9-8.
The fencer Hsieh became the first SAR athlete to step on the podium in two University Games, having struck gold at the last edition in Chendu two years ago.
The tournament continues on Friday with fellow SAR fencers Daphne Chan, Sophia Wu and Janelle Leung appearing in the women’s individual foil, while Anthony Yuen and Ng Ting-hin will compete in the men’s individual epee.