A compact medical treatment tool having an end portion, used for surgery, and a surgical system having such a medical treatment tool are provided. A medical treatment tool includes an end effector, a wrist member, a shaft, a first pulley, and a second pulley. A first pulley portion included in the end effector is rotatably mounted on the wrist member via a first connection, and is located closer to a first end of the first connection. The first pulley is mounted on the wrist member. A rotational axis of the first pulley intersects with a plane defined by a shaft axis and a first axis that is defined by the first connection. The rotational axis of the first pulley is located closer to a second end of the first connection, opposite to the first end of the first connection, than a groove of the first pulley portion.
