Purpose/Hypothesis: Urologic Chronic Pelvic Pain (UCPP) includes Painful Bladder Syndrome (PBS) or Interstitial Cystitis (IC) in men and women, and Chronic Prostatitis/Pelvic Pain Syndrome (CPPS) in men. Manual physical therapy is commonly utilized for the treatment of UCPP. However, there is no strong evidence to support its use. Our objective was to determine the feasibility of a randomized study of manual physical therapy and estimate efficacy. Number of Subjects: In our pilot study, 47 participants with symptom duration of less than 3 years were recruited at six clinical centers. Materials/Methods: We recruited men and women with a clinical diagnosis of PBS/IC, with both bladder pain and frequency rated 3/10 or greater. We also recruited males with CPPS who had NIH-CPSI scores >15, with >1 in the pain domain. All subjects had pelvic floor muscle tenderness on examination. Physical therapists at each clinical center were certified in the performance of two standardized manual therapies. Patients were randomized to undergo 10 weekly one hour treatments of either manual physical therapy (MPT) or traditional massage. The MPT group underwent manual techniques including connective tissue manipulation, myofascial release, and trigger point release to body wall tissues of abdominal wall, back, buttocks, thighs and internal pelvic floor that clinically were found to contain connective tissue abnormalities or painful trigger points. Patients randomized to the massage group underwent total body massage therapy without internal treatment. After completing the course of treatment to the primary efficacy endpoint, the Patient Global Response Assessment, was blindly assessed. Patients were considered to be "responders" if they indicated that compared to before treatment, their symptoms were either 'moderately' or 'markedly' improved. Responder rates were compared using Mantel-Haenszel test. Results: 47 participants (23 males, 24 females) were randomized to MPT (n=23) or massage (n=24). Study groups were comparable; overall 93% had moderate/severe pain and 91% had moderate/severe urgency at baseline. In the MPT group 13/23(57%) were responders, compared to 5/24(21%) in the massage group (p=0.03). There were no serious adverse events and 44/47 (94%) completed therapy. Conclusions: This novel study suggests that it is feasible to perform a randomized trial studying MPT for the treatment of UCPP. Clinical Relevance: This pilot study suggests that manual physical therapy may be an efficacious treatment for patients with UCPP.