Patients with fibromyalgia syndrome suffer from physical exhaustion due to sleep disturbances, causing despondency and lack of energy. Middle age women exhibit a higher prevalence for the diagnosis of fibromyalgia. A decreased tolerance to physical exertion has been observed in this patient, making them to refuse physical activity. Manual therapy intervention has been study as an alternative treatments to manage signs and symptoms in this population. The aim of this study was to review current evidence examining the effectiveness of manual therapy interventions in reducing symptoms and improving quality of life of women diagnosed with fibromyalgia. A comprehensive systematic review of peer-reviewed publications in English and Spanish languages from 1995 to March 2012 was completed using the following databases: EBSCOHost, CINAHL, Science Direct, Medline, Pub Med and Scopus. A data extraction table was used to analyze studies that complied with the inclusion criteria. A total of 57 articles were retrieved. Only eight studies met the inclusion criteria. Of these, six were RCT and two were quasi experimental studies. The manual therapies found in the studies were: massage therapy, craniosacral therapy, combination of manual lymph drainage therapy massage, manipulation techniques, muscle energy techniques combined with myofascial release and craniosacral therapy. In conclusion, it can be suggested by the results that manual therapy could be an alternative and safe treatment for decreasing symptoms and improve quality of life in patients with FS. However, this suggestion cannot be generalized regarding the effectiveness of manual therapy in reducing symptoms and improving quality of life.