Abstract: Quantum cosmology based on Lorentzian path integrals is a promising avenue. However, many previous works allow non-Lorentzian configurations by integrating the squared scale factor over the whole real line. Here we show that restricting the minisuperspace path integral to Lorentzian configurations with positive squared scale factor can significantly change the expectation values. In addition, this enables the study of causal horizons and their quantum fluctuations, and achieves singularity avoidance trivially by excluding singular minisuperspace geometries as non-Lorentzian. The results indicate that semiclassical saddle point approximation is not always valid in truly Lorentzian quantum cosmology. As a consequence, related works on the tunneling and no-boundary proposals, bouncing cosmology, and the quantum origin of inflation etc. need to be reexamined.