Objective: The purpose of this study was to investigate local paraspinal cutaneous temperature (CT) modifications after spinal manipulative therapy at L5. Methods: Twenty subjects with acute low back symptoms were randomly assigned to either a treatment or a sham group (n = 10 per group). Subjects underwent an 8-minute acclimatizing period. Temperature was measured bilaterally with infrared cameras at the L5 level. In the treatment group, a traditional chiropractic manipulation (lumbar roll technique with a pisiform contact on the ipsilateral mamillary of L5) was delivered, whereas with the sham group, the same technique was used, but no thrust was applied. Cutaneous temperature control measurements were taken 2 minutes before (t(-2)) and immediately after the intervention (t(0)) and at 1, 3, 5, and 10 minutes postintervention (t(1), t(3), t(5), and t(10), respectively). Results: At t(0), CT in the treatment group on the treatment side (ipsilateral side) warmed up by 0.2 degrees F, whereas in the sham group, there were no significant temperature modifications on either side. At t(3) relative to t(0), CT in the treatment group on the treatment side warmed by approximately 0.6 degrees F, whereas the contralateral side (nontreatment side) cooled. In the treatment group, significant differences were noted between sides (F = 13.36, P = .002, P = .932) and sides x times (F = 2.97, P = .016, P = .838). Conclusion: The effects of a lumbar spine manipulation appear noticeable by changes in paraspinal CT measurements at the level of L5. However, the meaning and mechanisms of CT modifications at L5 are still being investigated.