To assess the segmental specificity, or accuracy, of osteopathic lumbar spinal manipulations.Prior studies of chiropractic technique of manual manipulations of the spine designed to target abnormal tissue have been shown to be inaccurate, resulting in adjustments of segments other than the targeted level. This can result in manipulations of areas other than the level of interest of a therapist.Cross-sectional investigation of a convenience sample. Twenty subjects, 14 males and 6 females (mean age = 31.2 years), participated. Eighteen subjects received 2 manipulations and 2 subjects received 3 manipulations that were performed by an experienced osteopath, totalling 42 manipulations. If present, cavitations were recorded using accelerometers from which, quantifying the time to target, revealed the source location. The osteopath and subjects were also asked to report their perception regarding any “clicking” (signifying a cavitation) during manipulations.In 12 of the 20 subjects (60%) there was at least one cavitation recorded. Sixteen of the 38 recorded manipulations produced at least one cavitation. Eight (50%) of these were accurate to the intended target. The mean distance between the site of cavitation and the intended target (error) was 5.31 cm. Regression analysis revealed no statistically significant relationship between the site of cavitation and intended target (p = 0.718). There was an increased number of attempts to adjust upper lumbar segments (L1, L2) compared to lower segments (L3, L4); however, there was error inferior to the target segment for 18 of the 23 cavitations (78%).These results suggest that osteopathic techniques employed in this study were no different in terms of accurately directing treatment to a specified spinal segment (the mean error was 1 segment away from the intended target segment) than those previously observed using chiropractic techniques.