Manzo first appeared on the first season of Bravo's The Real Housewives of New Jersey in 2009. Her sister, Dina Manzo (now Dina Cantin), and sister-in-law, Jacqueline Laurita, were also cast members when the show first aired. Manzo departed The Real Housewives after its fifth season and began filming a spin-off series about her family called Manzo'd with Children. The show premiered on October 5, 2014, on Bravo; it attracted over 1.7 million viewers. In March 2015, Bravo renewed Manzo'd with Children for a second season. In April 2016, it was renewed for a third season. In February 2017, it was announced the series would not return for a fourth season.
Manzo has written a book entitled Let Me Tell You Something which was released on December 1, 2013, by HarperCollins.
Manzo was offered a part-time role on the tenth season of The Real Housewives of New Jersey, but turned it down, finding the offer "insulting". In 2022, Manzo confirmed that she was asked to return for the thirteen season of the The Real Housewives of New Jersey as a full-time housewife, but once again declined the offer.

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