It is rather popular of spinal manipulative therapy (SMT) in the west as well as it is in the east. Along with the fast developing of modem medicine in the past decade, the mechanism of SMT showed many different ideas in the Eastern and Western countries. The recent study on the mechanism of SMT in Western countries had widely focused on aspect of the stress reaction of joint and neurobiological effect of manipulative loading. Method of study involved in immunohistochemical, anatomic, nerve myoelectrical aspects and so on. The results have showed the two sides of SMT from many aspects and challenged our belief if we could have it systematically integrated into modern medicine along with the deep understanding continuing progressed. We could positively learn something from the studies and absorb some constructive viewpoints of their analysis by the review.