Eleven randomized trials with a total of 994 radical cervical spondylosis patients were included in this systematic review and meta-analysis comparing manipulation (n=525) and cervical traction (n=469). The primary outcome of interest was short-term efficacy (as determined by Chinese medicine literature standards). Secondary outcomes of interest included the improvement from baseline in Visual Analog Scale (VAS) pain scores, neck pain scores, upper limb anesthesia, and survivorship. The results found that manipulation provided significantly better short-term efficacy, VAS pain improvement, upper limb anesthesia improvement, and viability improvement vs. cervical traction. For short-term efficacy, sub-group analyses by manipulation type found rotational manipulation to provide significant benefits over cervical traction, with no improvement observed in pulling/distraction manipulation vs. cervical traction.