OBJECTIVE To reveal the complex interaction mechanism of the driving factors for the digital transformation of traditional Chinese medicine enterprises from the perspective of configuration, providing theoretical reference and practical inspiration for them to break through the barriers of traditional production models and successfully implement digital transformation.

METHODS Based on the theoretical framework of “technology-organization-environment” and fuzzy set qualitative comparative analysis, 54 listed Chinese medicine companies were selected as samples to explore the configuration effects of factors affecting digital transformation of Chinese medicine enterprises.

RESULTS There were three pathways to drive the high-level digital transformation of Chinese medicine enterprises, which were resource-utilization, opportunity-perception, and comprehensive-collaboration. Three pathways were also identified as leading to the low-level digital transformation of traditional Chinese medicine enterprises, which were characterized by a lack of environmental support, insufficient development capacity, and weak transformation awareness. Moreover, asymmetry was observed with the pathways of high-level digital transformation.

CONCLUSION The success of digital transformation of traditional Chinese medicine enterprises is not driven by a single factor. The level of financial guarantee is a key factor for traditional Chinese medicine enterprises to achieve digital transformation. The growth potential of enterprises and the support from the external environment achieve digital transformation through equivalent substitution effects.