The aim of this systematic review is to determine the effectiveness of manual therapy applied alone on pain, function, symptom severity, nerve conduction and strength in people with carpal tunnel syndrome. We searched MEDLINE, WOS, SCOPUS, PEDro, CENTRAL, LILACS and Epistemonikos. Twelve studies met the eligibility criteria and nine were included in the quantitative synthesis. Pain had a standardized mean difference of - 1.83 (95% CI = - 2.62, - 1.03, p = < .00001), function a mean difference of - 0.88 (95% CI = - 1.05, - 0.71, p = < .00001), symptom severity a mean difference of - 0.94 (95% CI = - 1.58, - 0.30, p = .004), sensory conduction velocity a mean difference of 7.46 (95% CI = - 0.11, 14. 98, p = .05), motor conduction velocity a mean difference of 1.85 (95% CI = 0.68, 3.01, p = .002), motor latency a mean difference = - 0.57, (95% CI = - 0.96, - 0. 17, p = .005), grip strength a mean difference = -0.24, 95% CI = - 2.22, 1.74, p = .81) and grip strength a mean difference = 0.21 (95% CI = - 0.42, 0.83, p = .52). Finally, it is concluded that manual therapy applied alone is an effective short-term option for people with mild to moderate carpal tunnel syndrome.