There is currently no gold standard treatment for mechanical neck pain. This systematic review assessed 6 randomized controlled trials (RCTs) to evaluate the effects of thoracic spine thrust manipulation on pain, range of motion, and self-reported function in patients with mechanical neck pain. Results revealed that this treatment led to short-term improvement in patients with acute or subacute mechanical neck pain. However, readers should be apprehensive when drawing conclusions from this systematic review, due to the large variability between studies.