Background: Individuals suffering from myofascial pain syndrome in the neck and upper back frequently experience discomfort and reduced functionality due to the presence of active trigger points. Various ultrasound therapy methods are commonly employed to address and alleviate these symptoms associated with MPS. Objective: To assess and contrast various ultrasound therapy approaches in terms of their effectiveness in reducing pain measured on the visual analog scale (VAS), enhancing range of motion, elevating pressure pain threshold (PPT) scores, and ameliorating function according to the Neck Disability Index (NDI) for patients experiencing myofascial pain syndrome in the neck and upper back. Methods: The study adhered to the PRISMA guidelines for reporting systematic reviews of randomized controlled trials and employed systematic review methods outlined in the Cochrane Handbook. Only randomized controlled trials (RCTs) with individual or cluster-level randomization were included to minimize selection bias. Results: The reviewed techniques included conventional ultrasound, trigger point therapy, sham ultrasound, high-power pain threshold static ultrasound, and the HPPT-9 technique. All studies addressed treatments targeting either the cervical spine, shoulder, or scapular muscles. While some studies evaluated a single technique, others combined multiple methods. The HPPTUS technique demonstrated superior effectiveness for managing myofascial trigger points (MTrPs) compared to traditional ultrasound. However, variations in approaches across studies led to both comparable and differing therapeutic outcomes by the final follow-up week. Conclusion: Based on the comprehensive analysis of the available literature, it is evident that various ultrasound techniques exhibit an impact on myofascial trigger points. However, it is worth noting that HPPT static ultrasound stands out as particularly effective, demonstrating superior outcomes in the treatment of myofascial trigger points. Consequently, it can be considered a viable and promising approach for managing trigger points in clinical practice.