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