Background: Pressure release and thoracic manipulation techniques have been proven separately to have positive effect in treating the myofascial pain syndrome with active Rhomboids-trigger points. Objective: To compare the effects of pressure release in combination with thoracic manipulation in treating the myofascial pain syndrome with active Rhomboids-trigger points. Methods: Sixty–six participants, age ranging from 18 to 30 years suffering from active rhomboids trigger points in case of myofascial pain syndrome were randomly assigned into three equal groups. Group A was given traditional physiotherapy. Group B was given traditional physiotherapy in addition to pressure release. Group C was given traditional physiotherapy in addition to thoracic manipulation. Each group received treatments for three weeks/three sessions per week. Pre and post measurements were recorded measuring pain intensity level using visual analogue scale (VAS), thoracic range of motion (ROM) using digital inclinometer, pain pressure threshold (PPT) using digital algometer and measuring physical function of upper limb using Arabic-DASH questionnaire. Results: following intervention for each group, there was significant decline in VAS and DASH scores, significant improvement in PPT and thoracic ROM compared to pre-treatment. Among groups comparison revealed that there was a significant decrease in visual analogue scale and DASH in group B and C compared with that in group A (p < 0.01). There was a significant increase in pain pressure threshold and thoracic range of in group B and C compared with group A (p < 0.05). There was no significant difference in VAS score, PPT (kg/cm), thoracic range of motion in degree and DASH questionnaire score between group B and C (p > 0.05). Conclusion: Addition of either pressure release or thoracic manipulation to conventional physical therapy has shown clinical importance as the percentage of improvement in all parameters increased except in flexion range of motion, improved pain intensity level, thoracic ROM, ppt and physical function. So, both techniques are equally effective in treating the myofascial pain syndrome with active Rhomboids-trigger points.