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International organizations (IOs) experience significant variation in their decision-making performance. While some are efficient decision-making machineries, others are plagued by gridlock. How can such variation be explained? This paper offers the first systematic and comparative analysis of the decision-making performance of IOs. Empirically, we map and evaluate the decision-making of 30 IOs over the time period 1980-2011. The dataset operationalizes decision-making performance as the annual change in output of an IO’s main interstate decision-making body. Theoretically, we advance a rational institutionalist argument centered on three features of the decision-making setting: pooling, delegation, and TNA access. Broadly in line with the theory, we demonstrate that variation in decision-making performance depends on whether the institutional design of IOs provides for majority voting rules, independent supranational bodies, and opportunities for TNA involvement. Independently and in combination, these features of IOs constrain and enable collective decision-making. These findings suggest that institutional design systematically shapes the capacity of IOs to meet policy challenges through decision-making.