This medical manipulator (10) is provided with a distal-end moving section (14) comprising an end effector (12). The distal-end moving section (14) includes a rotating sleeve (56) (a distal-end rotator) which is able to rotate integrally with the end effector (12) about a roll axis and has a hollow cylindrical portion, and a distal-end fulcrum block (58) (rotary support cylinder) which is provided so as to be able to change orientation in relation to the axial direction of a shaft (18) and rotatably supports the rotating sleeve (56) at an inner peripheral section. A part of an opening/closing driving transmission section (80) (actuating means (21)) for transmitting an opening/closing driving force to the end effector (12) is disposed inside of the distal-end moving section (14).