Topological spin textures in chiral magnets such as manganese germanide (MnGe) are of fundamental interest and may enable magnetic storage and computing technologies. Our spin-polarized scanning tunneling microscopy images of MnGe thin films reveal a variety of textures that are correlated to the atomic-scale structure. Our images indicate helical stripe domains, in contrast to bulk, and associated helimagnetic domain walls. In combination with micromagnetic modeling, we can deduce the three-dimensional (3D) orientation of the helical wave vectors, and we find that three helical domains can meet in two distinct ways to produce either a “target-like” or a “π-like” topological spin texture. The target-like texture can be reversibly manipulated through either current/voltage pulsing or applied magnetic field, which represents a promising step toward future applications.