The American golfer, 28, struck the supporter in the face on the short, par-four sixth hole attempting a monster drive.
Koepka had hoped to go from tee to green in one shot and set himself up an eagle putt.
However, his huge swing on day one of the 2018 Ryder Cup resulted in a fan taking the brunt of the ball.
Rich Beem, on-course commentator for Sky Sports, said Koepka was clearly shaken-up as he missed a number of putts.
Beem added the supporter had suffered a nasty injury after the ball hit her just above the eye.
Koepka, who won the US Open and US PGA this year, then went miles left with his tee shot off the seventh tee, narrowly missing more spectators lining the fairway.
Tony Finau joined Koepka for the US on day one for the four-balls – taking on Justin Rose and Jon Rahm for Europe.
Elsewhere, huge names such as Rory McIlroy and Tiger Woods got their tournament underway aiming to get their hands on the famous trophy.
As yet, there has been no injury update on the stricken supporter.
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