This paper seeks to identify the causal contexts that lead Latin American IOs to remain active and which causal paths lead them to paralysis. For that, this study evaluates conditions and combination of conditions pointed out by the literature using qualitative comparative analysis (QCA). It explores 31 IOs in the Americas. The findings show that having adequate staff is crucial for an IO to maintain regular activities in the region. Having high-quality staff and a large team is sufficient to keep regular operations, with the possible tradeoff either by restricting IOs’ scope or having a high number of member-states. Conversely, it was found that a more complex combination of institutional features and external aspects are needed for their paralysis to occur.