content: <?xml version="1.0" encoding="UTF-8"?><edgarSubmission xmlns="http://www.sec.gov/edgar/ownership" xmlns:com="http://www.sec.gov/edgar/common">
    <!-- Generated by Workiva -->
    <headerData>
      <submissionType>144</submissionType>
      <filerInfo>
        <filer>
          <filerCredentials>
            <cik>0001325712</cik>
            <ccc>XXXXXXXX</ccc>
          </filerCredentials>
        </filer>
        <liveTestFlag>LIVE</liveTestFlag>
  
  
  
      </filerInfo>
    </headerData>
    <formData>
      <issuerInfo>
        <issuerCik>0001157601</issuerCik>
        <issuerName>Madrigal Pharmaceuticals, Inc.</issuerName>
        <secFileNumber>001-33277</secFileNumber>
        <issuerAddress>
          <com:street1>200 Barr Harbor Drive, Suite 200</com:street1>
          <com:city>West Conshohocken</com:city>
          <com:stateOrCountry>PA</com:stateOrCountry>
          <com:zipCode>19428</com:zipCode>
        </issuerAddress>
        <issuerContactPhone>2678242827</issuerContactPhone>
        <nameOfPersonForWhoseAccountTheSecuritiesAreToBeSold>Keith R. Gollust</nameOfPersonForWhoseAccountTheSecuritiesAreToBeSold>
        <relationshipsToIssuer>
          <relationshipToIssuer>Former Affiliate</relationshipToIssuer>
        </relationshipsToIssuer>
      </issuerInfo>
      <securitiesInformation>
        <securitiesClassTitle>Common</securitiesClassTitle>
        <brokerOrMarketmakerDetails>
          <name>J.P. Morgan Securities LLC</name>
          <address>
            <com:street1>390 Madison Avenue - 6th Floor</com:street1>
            <com:city>New York</com:city>
            <com:stateOrCountry>NY</com:stateOrCountry>
            <com:zipCode>10017</com:zipCode>
          </address>
        </brokerOrMarketmakerDetails>
        <noOfUnitsSold>11477</noOfUnitsSold>
        <aggregateMarketValue>2699619.94</aggregateMarketValue>
        <noOfUnitsOutstanding>18289173</noOfUnitsOutstanding>
        <approxSaleDate>06/26/2023</approxSaleDate>
        <securitiesExchangeName>Nasdaq</securitiesExchangeName>
      </securitiesInformation>
      <securitiesToBeSold>
        <securitiesClassTitle>Common</securitiesClassTitle>
        <acquiredDate>07/15/2008</acquiredDate>
        <natureOfAcquisitionTransaction>Open Market Purchase</natureOfAcquisitionTransaction>
        <nameOfPersonfromWhomAcquired>See Nature of Acquisition Transaction</nameOfPersonfromWhomAcquired>
        <isGiftTransaction>N</isGiftTransaction>
        <amountOfSecuritiesAcquired>11477</amountOfSecuritiesAcquired>
        <paymentDate>07/15/2008</paymentDate>
        <natureOfPayment>Cash</natureOfPayment>
      </securitiesToBeSold>
      <nothingToReportFlagOnSecuritiesSoldInPast3Months>Y</nothingToReportFlagOnSecuritiesSoldInPast3Months>
      <noticeSignature>
        <noticeDate>06/26/2023</noticeDate>
        <signature>/s/ J.P. Morgan Securities LLC as agent and attorney-in-fact for Keith R. Gollust</signature>
      </noticeSignature>
    </formData>
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text: 144
  0001325712
  XXXXXXXX
  LIVE
  0001157601
  Madrigal Pharmaceuticals, Inc.
  001-33277
  200 Barr Harbor Drive, Suite 200
  West Conshohocken
  PA
  19428
  2678242827
  Keith R. Gollust
  Former Affiliate
  Common
  J.P. Morgan Securities LLC
  390 Madison Avenue - 6th Floor
  New York
  NY
  10017
  11477
  2699619.94
  18289173
  06/26/2023
  Nasdaq
  Common
  07/15/2008
  Open Market Purchase
  See Nature of Acquisition Transaction
  N
  11477
  07/15/2008
  Cash
  Y
  06/26/2023
  /s/ J.P. Morgan Securities LLC as agent and attorney-in-fact for Keith R. Gollust