Abstract: Fibromyalgia is a chronic pain syndrome characterized by widespread musculoskeletal pain, fatigue, sleep disturbances, and cognitive dysfunction. While pharmacologic therapies and lifestyle modifications are commonly used, many patients experience suboptimal relief. We present the case of a 41-year-old African American female with a seven-year history of fibromyalgia, who sought care in a family medicine clinic for persistent pain, fatigue, and functional impairment despite ongoing pharmacologic management. Osteopathic manipulative treatment (OMT) was initiated during her visit, including soft tissue, myofascial release, articulatory, muscle energy, and high-velocity low-amplitude (HVLA) techniques applied to the cervical, thoracic, and lumbar spine, as well as the upper and lower extremities. The patient experienced immediate and significant relief following the first session, with direct OMT techniques seeming to have the most substantial impact in reducing symptoms. For six weekly sessions, all previously applied techniques were consistently repeated and adapted to address ongoing somatic dysfunction. The patient reported a reduction in pain intensity from 7/10 to 2/10, along with improvements in sleep quality, mood, and physical function. Post-treatment examination revealed decreased muscle tenderness and enhanced segmental mobility, with these improvements remaining stable at eight-week follow-up. This case highlights the potential of OMT, particularly direct techniques, to provide substantial symptom reduction in fibromyalgia patients, although lasting relief may require further interventions and follow-up.