Aim: The study aims to compare the effects of thoracic spinal adjustment and multimodal physical therapy to those of multimodal physical therapy alone in patients with cervicothoracic dorsalgia. Methods: This single-center, prospective, randomized, clinical study included a total of 43 patients diagnosed with cervicothoracic dorsalgia (aged 20-55; 22 female and 21 male), was conducted between March 2019 and February 2020. The participants were randomly assigned into 2 groups: Multimodal Physical therapy (MPT, n=21) and MPT plus thoracic spinal adjustment (MPT+TSA; n=22). In MPT group, modalities including hot packs, transcutaneous electrical nerve stimulation (TENS), therapeutic ultrasound and neck-posture exercises were applied for 15 sessions. MPT + TSA group received the same MPT approach, with the addition of TSA once a week during 4 weeks of treatment. The Spinal Mouse® posture analysis for thoracic kyphosis and thoracic mobility, Visual Analog Scale (VAS) for pain, Neck Disability Index (NDI), Quebec back pain questionnaire (Quebec) were assessed at baseline and 4th week. Results: The intra-group comparison outcomes revealed significant improvement in VAS, NDI, Quebec for both groups (MPT and MPT + TSA; p<0.05). However, post-treatment postural analysis was not statistically significant when compared with pre-treatment value for both groups. Besides, there was no statistically significant difference between MPT and MPT + TSA groups for all outcomes. Conclusions: Our study results suggest that adding 4 sessions of chiropractic thoracic adjustment to MPT for cervicothoracic dorsalgia may not influence the outcomes significantly. Further research with large sample size, longer duration and more frequent spinal adjustment is necessary to determine the effectiveness of chiropractic therapy in treating patients with cervicothoracic dorsalgia.