The annual feast of the Black Nazarene features a centuries-old life-size blackened statue of Jesus, which people try to kiss or touch, believing it to possess miraculous powers.
Officials said 3.5 million barefoot devotees on Tuesday attended the "generally peaceful" event, despite crowds jostling to touch the icon.
However, police say a man died of a heart attack as he joined a number of people who attempted to climb onto the carriage bearing the Black Nazarene as it arrived at the Quiapo Church in Manila.
This is not the first time the festival has been marred with a death.
In 2016, two people died during the event in the mainly Catholic Asian nation.
Injuries included a suspected neck and spine injury in a fall, according to the Philippine Red Cross.
During the parade, police shut down mobile phone signals in many areas of Manila to prevent potential terror attacks on the procession.
