Purpose <p>Given the critical role of fathers in the care of children with ASD, while prior research has neglected the mechanism by which multi-level factors interact to shape paternal involvement, this study aims to explore the configurational pathways of multi-level factors influencing the involvement of Chinese fathers of children with ASD, under the guidance of Bronfenbrenner’s ecosystem theory and by adopting the fuzzy-set qualitative comparative analysis (fsQCA) method. Specifically, this study intends to clarify how different combinations of individual, intrafamilial, and extrafamilial factors affect paternal involvement, identify the necessary conditions and key drivers therein.</p> Methods <p>This study employed fuzzy-set qualitative comparative analysis (fsQCA) - a method uniquely suited to analyze multi-level interactions - to investigate configurational pathways influencing paternal involvement among 203 Chinese fathers of children with ASD.</p> Results <p>Necessity analysis showed high-frequency couple interaction as a necessary condition (consistency &gt; 0.9, coverage &gt; 0.5) across all configurations, underscoring intrafamilial dynamics’ primacy. Five configurations emerged, forming three theoretically distinct models according to ecosystem theory: Individual-Familial Synergy, Intrafamilial-Extrafamilial Support, and Integrated Ecosystem. Key drivers included: working within the public institution (individual), high frequency of couple interaction (intrafamilial), high level of community support (extrafamilial), and high level of other support (extrafamilial).</p> Conclusions <p>Paternal involvement in ASD care is the result of the conjunctural effect of multi-level factors, and the configurational pathways for high and low involvement are asymmetric. The core role of intrafamilial interaction and the synergy mechanism of individual, family, and external systems provide important insights for formulating targeted interventions to improve paternal involvement.</p>