content: <?xml version="1.0" encoding="UTF-8"?><edgarSubmission xmlns="http://www.sec.gov/edgar/ownership" xmlns:xsd="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
  <headerData>
  <submissionType>144</submissionType>
  <filerInfo>
  <filer>
  <filerCredentials>
  <cik>0002001571</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>
  <street1 xmlns="http://www.sec.gov/edgar/common">Four Towers Bridge</street1>
  <street2 xmlns="http://www.sec.gov/edgar/common">200 Barr Harbor Drive, Suite 200</street2>
  <city xmlns="http://www.sec.gov/edgar/common">West Conshohocken</city>
  <stateOrCountry xmlns="http://www.sec.gov/edgar/common">PA</stateOrCountry>
  <zipCode xmlns="http://www.sec.gov/edgar/common">19428</zipCode>
  </issuerAddress>
  <issuerContactPhone>267-824-2827</issuerContactPhone>
  <nameOfPersonForWhoseAccountTheSecuritiesAreToBeSold>Carole Huntsman</nameOfPersonForWhoseAccountTheSecuritiesAreToBeSold>
  <relationshipsToIssuer>
  <relationshipToIssuer>Officer</relationshipToIssuer>
  </relationshipsToIssuer>
  </issuerInfo>
  <securitiesInformation>
  <securitiesClassTitle>Common Stock</securitiesClassTitle>
  <brokerOrMarketmakerDetails>
  <name>Morgan Stanley Smith Barney LLC Executive Financial Services</name>
  <address>
  <street1 xmlns="http://www.sec.gov/edgar/common">1 New York Plaza, 8th Floor</street1>
  <city xmlns="http://www.sec.gov/edgar/common">New York</city>
  <stateOrCountry xmlns="http://www.sec.gov/edgar/common">NY</stateOrCountry>
  <zipCode xmlns="http://www.sec.gov/edgar/common">10004</zipCode>
  </address>
  </brokerOrMarketmakerDetails>
  <noOfUnitsSold>347</noOfUnitsSold>
  <aggregateMarketValue>118028.58</aggregateMarketValue>
  <noOfUnitsOutstanding>21810407</noOfUnitsOutstanding>
  <approxSaleDate>01/24/2025</approxSaleDate>
  <securitiesExchangeName>Nasdaq Stock Market</securitiesExchangeName>
  </securitiesInformation>
  <securitiesToBeSold>
  <securitiesClassTitle>Common Stock</securitiesClassTitle>
  <acquiredDate>01/23/2025</acquiredDate>
  <natureOfAcquisitionTransaction>Restricted Stock Unit Grant</natureOfAcquisitionTransaction>
  <nameOfPersonfromWhomAcquired>Issuer</nameOfPersonfromWhomAcquired>
  <isGiftTransaction>N</isGiftTransaction>
  <amountOfSecuritiesAcquired>347</amountOfSecuritiesAcquired>
  <paymentDate>01/23/2025</paymentDate>
  <natureOfPayment>Vesting of Restricted Stock Units</natureOfPayment>
  </securitiesToBeSold>
  <nothingToReportFlagOnSecuritiesSoldInPast3Months>N</nothingToReportFlagOnSecuritiesSoldInPast3Months>
  <securitiesSoldInPast3Months>
  <sellerDetails>
  <name>Carole Huntsman</name>
  <address>
  <street1 xmlns="http://www.sec.gov/edgar/common">C/O MADRIGAL PHARMACEUTICALS, INC.</street1>
  <street2 xmlns="http://www.sec.gov/edgar/common">200 BARR HARBOR DRIVE, SUITE 200</street2>
  <city xmlns="http://www.sec.gov/edgar/common">WEST CONSHOHOCKEN</city>
  <stateOrCountry xmlns="http://www.sec.gov/edgar/common">PA</stateOrCountry>
  <zipCode xmlns="http://www.sec.gov/edgar/common">19428</zipCode>
  </address>
  </sellerDetails>
  <securitiesClassTitle>Common Stock</securitiesClassTitle>
  <saleDate>11/21/2024</saleDate>
  <amountOfSecuritiesSold>688</amountOfSecuritiesSold>
  <grossProceeds>218040.96</grossProceeds>
  </securitiesSoldInPast3Months>
  <remarks>The sale of shares of common stock reported on this Form 144 represents the sale of shares pursuant to a sell-to-cover transaction in order to satisfy tax withholding obligations in connection with the vesting of Restricted Stock Units previously granted to the Reporting Person.</remarks>
  <noticeSignature>
  <noticeDate>01/24/2025</noticeDate>
  <signature>/s/ Carole Huntsman</signature>
  </noticeSignature>
  </formData>
  </edgarSubmission>
metadata_documents: [{"type": "144", "sequence": "1", "filename": "primary_doc.xml", "secsgml_size_bytes": 3875}]
text: 144
  0002001571
  XXXXXXXX
  LIVE
  0001157601
  Madrigal Pharmaceuticals, Inc.
  001-33277
  Four Towers Bridge
  200 Barr Harbor Drive, Suite 200
  West Conshohocken
  PA
  19428
  267-824-2827
  Carole Huntsman
  Officer
  Common Stock
  Morgan Stanley Smith Barney LLC Executive Financial Services
  1 New York Plaza, 8th Floor
  New York
  NY
  10004
  347
  118028.58
  21810407
  01/24/2025
  Nasdaq Stock Market
  Common Stock
  01/23/2025
  Restricted Stock Unit Grant
  Issuer
  N
  347
  01/23/2025
  Vesting of Restricted Stock Units
  N
  Carole Huntsman
  C/O MADRIGAL PHARMACEUTICALS, INC.
  200 BARR HARBOR DRIVE, SUITE 200
  WEST CONSHOHOCKEN
  PA
  19428
  Common Stock
  11/21/2024
  688
  218040.96
  The sale of shares of common stock reported on this Form 144 represents the sale of shares pursuant to a sell-to-cover transaction in order to satisfy tax withholding obligations in connection with the vesting of Restricted Stock Units previously granted to the Reporting Person.
  01/24/2025
  /s/ Carole Huntsman