Headaches are one of the commonest neurological disorders with a global lifetime prevalence of 66 percent (1), and 82.7 percent in Singapore (2). Tension type headache (TTH) is the commonest primary headache with a lifetime prevalence of 30-78 percent globally (1). TTH is related to muscular factors (17) thus treatment directed toward muscular factors such as manual therapy can be considered (18). This review is aimed at evaluating the use of manual therapy for TTH.