Objective:To assess the effectiveness and safety of manipulation intervention for degenerative lumbar spondylolisthesis(DLS).Methods:This is a systematic review and meta-analysis.A full-scale retrieval method was performed until February 1,2021,including nine databases.The homogeneity of different studies was summarized using the Review Manager.The quality of studies was determined with the Cochrane risk-of-bias tool.The evidence quality was graded with the Grading of Recommendations,Assessment,Development,and Evaluations approach.Results:A total of 6 studies involving 524 participants were included.The review demonstrated that manipulation has statistically significant improvements for treating DLS according to Japanese Ortho-pedic Association scores(mean difference,3.76;95％confidence interval,2.63 to 4.90;P＜.001)and visual analog scale scores(mean difference,-1.50;95％confidence interval,-1.66 to-1.33;P＜.001)compared to the control group.One study reported that the difference in the Oswestry Disability Index between the traction group and the combination of manipulation and traction group was statistically significant(P＜.05),while another reported that manipulation treatment can significantly improve the lumbar spine rotation angle on X-ray images compared with the baseline data(P＜.05).Moreover,the manipulation group(experimental group)had fewer adverse events than the lumbar traction group(control group).Conclusion:Manipulation intervention is more effective and safer for DLS.Nevertheless,large-scale randomized controlled trials are required to confirm the current conclusions.