Structural and sequential ambidexterity are proved to be two prevalent approaches in managing tension between exploration and exploitation. Dominant studies have treated the two approaches as mutually exclusive but have provided less insight about their combination, and the organizational configurations that advance such combination, which is a major meaningful gap explored in the current study. This study aims to explore the configurations of organization design choices to combine structural and sequential approaches from a holistic perspective. We apply fuzzy-set qualitative comparative analysis (fsQCA) to analyze the empirical data collected from 102 firms in China. The results show that firms attain high ambidexterity with both separated and blended configurations. Blended ones demonstrate that the structural and sequential approaches can be combined in a way that one approach dominates and the other subordinates. Organizational design mechanisms regarding the configurations for combining structural and sequential approaches are concluded as multielements (complements and substitutes) and multilevels (fit and interaction). These findings are also interpreted through the Chinese ‘Yin-Yang’ framework, which introduces ‘Yin-Yang balancing’ into the ambidexterity literature.