Objective: To investigate the effect of spinal chiropractic manipulative therapy (SCMT) on the management of acute mountain sickness (AMS)-induced headache.Methods: One hundred individuals who traveled to Tibet between June and October 2015 were randomized to SCMT and standard AMS pain control groups. The primary endpoints were headache and vertigo improvement.Results: There were 58 men and 42 women (mean age, 39.3 ± 11.1 years) with no significant differences in sex and age between the SCMT and control groups. However, a history of both headache and hypertension was higher in the controls. The two groups showed significantly improved visual analog scale (VAS) pain scores at 10 minutes, 30 minutes, and 24 hours after treatment compared with baseline. The SCMT group showed higher baseline VAS scores compared with controls, but lower VAS scores at 30 minutes. Improvements were also noted in dizziness, blood pressure, and oxygen saturation. There were no adverse events.Conclusions: SCMT can be used to relieve AMS-induced headache, dizziness, blood pressure, and oxygen saturation of people traveling rapidly to high altitudes, but the symptoms were only evaluated for 24 hours. SCMT may be suitable for the management of AMS for patients who want to avoid drugs and oxygen inhalation.