Background <p>Medical disputes, with the progress of economic development and the improvement of people’s awareness of rights protection, are becoming increasingly intense. This phenomenon may have a negative impact on doctors and the medical system, especially village doctors who are responsible for guarding the health of rural people. Therefore, it is urgent to explore the factors that affect the medical dispute experience of village doctors.</p> Methods <p>A cross-sectional study was conducted and 1977 village doctors recruited from seven provinces in China during May to June 2023. Multivariate logistic regression with propensity score matching (PSM) was performed to explore the association of post competency and medical disputes.</p> Results <p>Among the 1977 village doctors, 208 (10.5%) had experienced medical disputes. Village doctors with high post competency (OR = 0.951, 95%CI: 0.930, 0.972), proficient western medicine (OR = 0.340, 95%CI: 0.164, 0.704), neutral occupational satisfaction (OR = 0.344, 95%CI: 0.216, 0.550), and neutral or high satisfying doctor–patient relationship (DPR) (OR = 0.401, 95%CI: 0.240, 0.668; OR = 0.200, 95%CI: 0.113, 0.355) had a decreased likelihood for medical disputes. Village doctors with high income (OR = 4.928, 95%CI: 2.039, 11.911) had an increased likelihood for medical disputes.</p> Conclusions <p>Village doctors who perceived themselves to have high service competency, high occupational satisfaction, and satisfaction with doctor–patient relationships were less likely to encounter medical disputes. The government and relevant organizations should intensify the training of village doctors, enhance their service competency and hospital facilities, foster harmonious doctor–patient relationships, and facilitate the advancement of primary public health services.</p>