Objective Guided by the perspective of resilience governance, this study analyzed the problems existing in the grassroots emergency management of sudden infectious diseases and explored the optimization paths, aiming to provide theoretical support and practical references for achieving the sustainable goal of grassroots emergency governance.

Methods Semi-structured in-depth interviews were conducted with members of the community public health committee in F District. Data were collected on community emergency management mechanisms, emergency response procedures and emergency response situations. Grounded theory methodology was applied to progressively refine, categorize and synthesize the raw data.

Results Themes emerged concerning the grassroots emergency management of sudden infectious diseases. Coding yielded 33 initial categories, comprising 16 primary categories and 4 core categories. The core categories included organizational resilience, institutional resilience, resource resilience and structural resilience. An optimization path for the emergency management of sudden infectious diseases that integrates multi-dimensional resilience elements across the entire governance cycle was constructed based on these core categories.

Conclusion To address the multidimensional resilience barriers at the grassroots level, efforts should be made to systematically enhance grassroots resilience governance capabilities by reorganizing organizational authority and responsibilities to strengthen organizational resilience; dynamically adapting systems to improve institutional resilience; intelligently allocating resources to consolidate resource resilience; and fostering structural resilience through multi-stakeholder participation.

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