Purpose: This study aimed to examine pacing strategies and identify the stroke that has the most significant impact on overall performance in men’s and women’s 200-m and 400-m individual-medley events from 2000 to 2021. Methods: The time in each lap and overall race was retrieved from the World Aquatics website. The standardized time for each stroke in individual medley was calculated by dividing the actual time by a reference time specific to each stroke. The reference time was derived from the respective laps in single-stroke finals in the 2017 World Swimming Championships. The decision-tree method was used for analysis. The dependent variables were qualified or nonqualified in heats and semifinals, and winning medals in finals. The independent variables were the ratio of standardized time in each stroke to the sum of standardized time in all 4 strokes. Results: Swimmers who spent a higher ratio of standardized time in the butterfly stroke (>0.236–0.245) are associated with a higher likelihood of winning medals or qualifying for the next stage in most men’s and women’s 200-m and 400-m individual medley. Butterfly exhibited the highest normalized importance that distinguished medalists from nonmedalists in the finals. The front-crawl stroke is the second most important determinant in medalists in men’s and women’s 200-m individual medley, whereas backstroke and breaststroke were the second most important in men’s and women’s 400-m individual medley, respectively. Conclusion: Individual-medley swimmers who were excellent in butterfly and conserved energy in butterfly had a higher likelihood of success.