Quantum-cascade (QC) vertical-cavity surface-emitting lasers (VCSELs) could combine the single longitudinal mode operation, low threshold currents, circular output beam, and on-wafer testing associated with VCSEL configuration and the unprecedented flexibility of QCs in terms of wavelength emission tuning in the infrared spectral range. The key component of QC VCSEL is the monolithic high-contrast grating (MHCG) inducing light polarization, which is required for stimulated emission in unipolar quantum wells. In this paper, we demonstrate a numerical model of the threshold operation of a QC VCSEL under the pulse regime. We discuss the physical phenomena that determine the architecture of QC VCSELs. We also explore mechanisms that influence QC VCSEL operation, with particular emphasis on voltage-driven gain cumulation as the primary mechanism limiting QC VCSEL efficiency. By numerical simulations, we perform a thorough analysis of the threshold operation of QC VCSELs. We consider the influence of optical and electrical aperture dimensions and reveal the range of aperture values that enable single transversal mode operation as well as low threshold currents.