The spinal manipulation in traditional Chinese medicine (TCM) has a prominent clinical advantage in the treatment of chronic lumbar pain, such as low back pain, but the insufficient basic research on manipulation is a serious obstacle to its development. Using finite element analysis (FEA) can preferably simulate the mechanics under various kinds of spinal manipulation, analyze its action mechanism, test the hypothesis, standardize the operating practices, make quantitative, qualitative and optimal treatment plans, so as to provide an effective method for the basic research on manipulation therapy. This paper reviews the FEA studies of spinal manipulation in recent years, discusses the influence of different spinal manipulation on intervertebral disc, lumbar accessory structures, spinal loads and mechanical stability of the vertebral body. The results show that current FEA studies on spinal manipulation need to make the simulation method standardized and precise. Meanwhile, the research ideas of finite element method should be developed to guide the clinical application of spinal manipulation.