In December 1967 he was appointed Chairman of the Economic Council. He was promoted to full membership of the Executive Committee of the PCR in December 1968 and, after holding various positions in the party and government, he became Prime Minister in March 1974, a position he held until 1979, when he retired, reportedly due to ill health.[3] Also in 1974 he became titular member of the Romanian Academy.[4]
Mănescu stayed close to Ceaușescu and his wife, Elena Ceaușescu up until the Romanian Revolution of 1989. He left the Central Committee's building by helicopter together with them on 22 December, though he had to disembark at Snagov due to too much weight in the craft. He was arrested shortly afterward and taken to the airbase at Deveselu, where he was kept in detention until 31 December. Tried in early 1990 together with Emil Bobu, Ion Dincă, and Tudor Postelnicu, Mănescu was sentenced to life in prison for participation in genocide; on appeal, his sentence was reduced to 10 years. He served two years in prison, and was set free on 12 November 1992 due to poor health.[4] Because of his conviction, he was stripped of his membership in the Romanian Academy.[5]
Mănescu's wife, Maria Munteanu Mănescu, was a well known pediatrician. In December 1973, she was named Vice Chairman of the Romanian Red Cross Society. She was also named a member of the (Romanian) National Council of Women in April 1978. It is not clear if the Mănescus had any children.