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Objective To analyze the influencing factors and improvement paths of the service capacity of standardized township health centers in Guangxi under the background of "high-quality service at the grassroots level", providing useful reference for further deepening reform and promoting the healthy development of rural medical and health systems. Methods By the end of 2021, township health centers that have reached the recommended standard of "quality service primary line" service ability were selected as the research samples, and the coupled coordination degree model was combined with fuzzy set qualitative comparative analysis method to carry out empirical analysis. Results Single factors cannot constitute a necessary condition for improving or decreasing the service capacity of township health centers. There are a total of four configuration paths for improving the service capacity of township health centers in Guangxi, among which the core sufficient conditions for playing a leading role are the number of high-level practicing (assistant) physicians, the number of registered nurses, and coupling coordination scheduling. The overall consistency of the solution is 0.920 (≥0.8), and the model has strong explanatory power. Conclusion The improvement of service capacity in township health centers in Guangxi is facilitated by the synergistic effect of multiple factors both internally and externally. The optimization and expansion of grassroots talent teams is the core combination element for the improvement of service capacity in township health centers, and the coupling and coordinated development of medical resource allocation and economy is the key element for the improvement of service capacity. [ABSTRACT FROM AUTHOR]