Purpose: With the increasing use of crowdfunding platforms in raising funds, it has become an important and oft-researched topic to analyze the critical factors associated with successful or failed crowdfunding. However, as a major subject of crowdfunding, medical crowdfunding has received much less scholarly attention. The purpose of this paper is to explore how contingency factors combine and casually connect in determining the success or failure of medical crowdfunding projects based on signal theory. Design/methodology/approach: The paper adopts the crisp-set qualitative comparative analysis to analyze the causal configurations of 200 projects posted on a leading medical crowdfunding platform in China “Tencent Donation.” Five anecdotal conditions that could have an impact on the outcome of medical crowdfunding campions were identified. Three relate to the project (funding duration, number of images and number of updates) and two relate to the funding participants (type of suffer and type of fund-raiser). Findings: The results show that diversified configurations of the aforementioned conditions are found (six configurations for successful medical crowdfunding projects and four configurations for failed ones). Originality/value: Despite the fact that there are a considerably large number of medical crowdfunding projects, relatively few researches have been conducted to investigate configurational paths to medical crowdfunding success and failure. It is found that there are certain combinations of conditions that are clearly superior to other configurations in explaining the observed outcomes.