A medical manipulator comprises a distal end working unit including a gripper as an end effector, an operating unit for operating the distal end working unit, a coupling interconnecting the distal end working unit and the operating unit, and an attitude changing mechanism for changing an attitude of the distal end working unit. When the operating unit is operated by an operator, the end effector is mechanically operated by a transmitting member. The attitude changing mechanism is operated by a bending drive source and a rotational drive source, which are operated when the operating unit is operated by the operator.