When responding to crises, a joint approach is often used, which requires coordination among government agencies and other institutions. In this article we combine the vertical and horizontal dimensions to develop a theoretical framework to explain the patterns and performance of coordination. By drawing on structural-instrumental and institutional perspectives, we examine the coordination structures and mechanisms in China's crisis management at the central and local levels. We outline the main structural characteristics of the Chinese system and the overall challenges it faces. We then discuss four crises that have happened in and around Beijing, using these to understand the crucial factors driving coordination successes and failures. Lastly, we discuss some comparative features and the theoretical and policy implications of our main results.