BACKGROUND: Massage is a common treatment in complementary and integrative medicine. Deep tissue massage, a form of therapeutic massage, has become more and more popular in recent years. Hence, the use of massage generally and deep tissue massage specifically, should be evaluated as any other modality of therapy to establish its efficacy and safety. AIM: To determine the definitions used for deep tissue massage in the scientific literature and to review the current scientific evidence for its efficacy and safety. METHODS: Narrative review. RESULTS: There is no commonly accepted definition of deep tissue massage in the literature. The definition most frequently used is the intention of the therapist. We suggest separating the definitions of deep massage and deep tissue massage as follows: deep massage should be used to describe the intention of the therapist to treat deep tissue by using any form of massage and deep tissue massage should be used to describe a specific and independent method of massage therapy, utilizing the specific set of principles and techniques as defined by Riggs: "The understanding of the layers of the body, and the ability to work with tissue in these layers to relax, lengthen, and release holding patterns in the most effective and energy efficient way possible within the client's parameters of comfort". Heterogeneity of techniques and protocols used in published studies have made it difficult to draw any clear conclusions. Favorable outcomes may result from deep tissue massage in pain populations and patients with decreased range of motion. In addition, several rare serious adverse events were found related to deep tissue massage, probably as a result of the forceful application of massage therapy. CONCLUSIONS: Future research of deep tissue massage should be based on a common definition, classification system and the use of common comparators as controls.