To provide a damping force adjustment type hydraulic shock absorber securing original performance of a damping force generating mechanism, and to provide a method of manufacturing the same.

An opening 14 of a separator tube 11 is approximately positioned to a fitting hole 17 of a base shell 3, and a passage member 20 is fitted in the opening 14, and a damping force generating mechanism 16 is fitted to the fitting hole 17, pushing it to a guide portion 23 of the passage member 20. With this structure, centering of the opening 14 is automatically done, and the separator tube 11 is positioned to a normal position relative to a cylinder 2. Consequently, a seal is prevented from being damaged, and sealability between the opening 14 and the damping force generating mechanism 16 is secured, and the damping force adjustment type hydraulic shock absorber 1 can thereby exhibit original performance.