The endoscope treatment tool 1 has a distal end member 3 which is installed in an endoscope. A connection member 4 is attached to the distal end member 3 in a freely rotatable manner. In the connection member 4, a portion which is supported by a cap 12 of the distal end member 3 is a second pivot shaft 15. A portion penetrating a supporting member 21 of a treatment portion 5 is a first pivot shaft 23. The first pivot shaft 23 is also a rotational axis of a pair of forceps members 22 provided in the treatment member 5. When the forceps members 22 are used, a coil sheath 6 is extended by an operation at the side of the proximal end. The connection member 4 rotates about the second pivot shaft 15, which is a fulcrum, and the treatment portion 5 moves forward beyond the cap 12. In accordance with the present invention, it is possible to resolve the difficulty of procedures by positioning the treatment portion in an appropriate location.