Abstract：Objective：To observe the clinical efficacy of balanced chiropractic and thoracic curvature adjustment therapy in the treatment of adolescent idiopathic scoliosis （AIS）. Methods： A total of 100 AIS adolescent patients admitted to Zhanjiang First Hospital of Traditional Chinese Medicine from July 2022 to April 2025 were selected and divided into the treatment group and the control group using the random number table method，with 50 cases in each group. The treatment group received balanced chiropractic and thoracic curvature adjustment therapy，while the control group received bone-setting and curvature adjustment therapy. Both groups were treated for three months. The Cobb angle and the angle of trunk rotation （ATR） were measured before and after treatment，the Scoliosis Research Society- 22 （SRS-22） questionnaire score was assessed， and the root mean square （RMS） values on the concave and convex sides of the apical vertebra were recorded. The clinical efficacy between the two groups was compared. Results：After treatment，the total effective rate in the treatment group was higher than that in the control group （P＜0.05）. The Cobb angle in both groups decreased compared with that before treatment （P＜0.05），and the Cobb angle in the treatment group was smaller than that in the control group （P＜0.05）. The SRS-22 scores for pain， function/activity， mental health，and self-image in both groups increased compared with those before treatment （P＜0.05）. The treatment group showed higher scores than the control group in pain， function/activity， mental health， self-image， and satisfaction domains （P＜0.05）. The RMS values on both the concave and convex sides of the apical vertebra increased in both groups compared with those before treatment （P＜0.05），with the treatment group exhibiting higher RMS values on both sides than the control group （P＜0.05）. The ATR values decreased in both groups compared with those before treatment （P＜0.05），and the treatment group had lower ATR values than the control group （P＜0.05）. Conclusion： The application of balanced chiropractic and thoracic curvature adjustment therapy in the treatment of AIS can effectively promote the recovery of paravertebral muscle function，improve scoliotic curvature，and enhance patients' quality of life.