Background: The purpose of this study was to identify the effects of cervical manipulation for improve blood velocity and flow in the subjects with asymmetric vertebral artery. Methods: Twenty-four subjects on asymmetric vertebral artery with right side have less blood flow than left side participated in this study for apply to non-specific cervical manipulation on lower portion. Measurement method were using duplex ultrasound with colour doppler imaging for blood velocity and flow on left and right vertebral artery. Results: Compared changes of blood velocity and flow on unilateral after the cervical manipulation, the left blood velocity decreased significantly (p<.01) and the right blood velocity increased significantly (p<.01). The left blood flow no significant changes and the right blood flow increased significantly (p<.01). Compared changes of blood velocity and flow on bilateral, the left and right blood velocity and flow made significantly difference on pre-manipulation (p<.01). However, both side no significantly difference on post-manipulation. Conclusions: These findings suggest that the non-specific cervical manipulation took effect for improve blood velocity and flow in the subjects with asymmetric vertebral artery. Therefore, therapeutic approaches for improve to asymmetric vertebral artery should be consider non-specific cervical manipulation.