The complexity of interregional crises challenges global emergency management, highlighting the need for enhanced intergovernmental emergency cooperation. The article focuses on the policy diffusion of intergovernmental public health emergency cooperation (IPHEC) among local governments, proposing an analytical framework that includes internal organizational characteristics, an external organizational environment, and interorganizational relationships. Using fuzzy-set qualitative comparative analysis (fsQCA), it finds four pathways influencing the policy diffusion of IPHEC: economic-pressure response, economic-crisis driven, resource-pressure driven, and resource-crisis-trust coordinated. Factors including economic development level, resource supply level, administrative pressure, crisis situation, and trust basis exhibit different operational logics within these four pathways.