An endoscopic treatment tool includes a sheath inserted into a treatment tool insertion channel； a treatment portion which is capable of protruding and retracting from a distal end of the sheath； and a manipulation main body. The manipulation main body includes a distal end-fixing portion capable of being fixed to a proximal end side-opening portion of the treatment tool insertion channel, an intermediate portion which is connected to a proximal end of the sheath and advances and retracts in a direction of a longitudinal axis of the sheath with respect to the distal end-fixing portion, a proximal end-manipulating unit to which a proximal end of the treatment portion is connected and which slides with respect to the intermediate portion, a fixing member provided on the manipulation main body, and a support member provided in the manipulation main body. One of the distal end-fixing portion and the intermediate portion is inserted and connected to the other thereof to partially overlap each other in the direction of the longitudinal axis, the support member is rotatably engaged with a member disposed on an outer side among the distal end-fixing portion and the intermediate portion, and the support member is configured to be able to fix the fixing member at an arbitrary position of the manipulation main body in the circumferential direction.
