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>0001574591</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>Mardi Dier</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>1187</noOfUnitsSold>
  <aggregateMarketValue>386833.69</aggregateMarketValue>
  <noOfUnitsOutstanding>22080246</noOfUnitsOutstanding>
  <approxSaleDate>03/03/2025</approxSaleDate>
  <securitiesExchangeName>Nasdaq Stock Market</securitiesExchangeName>
  </securitiesInformation>
  <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>774</noOfUnitsSold>
  <aggregateMarketValue>250416.63</aggregateMarketValue>
  <noOfUnitsOutstanding>22080246</noOfUnitsOutstanding>
  <approxSaleDate>03/03/2025</approxSaleDate>
  <securitiesExchangeName>Nasdaq Stock Market</securitiesExchangeName>
  </securitiesInformation>
  <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>258</noOfUnitsSold>
  <aggregateMarketValue>80875.26</aggregateMarketValue>
  <noOfUnitsOutstanding>22080246</noOfUnitsOutstanding>
  <approxSaleDate>03/10/2025</approxSaleDate>
  <securitiesExchangeName>Nasdaq Stock Market</securitiesExchangeName>
  </securitiesInformation>
  <securitiesToBeSold>
  <securitiesClassTitle>Common Stock</securitiesClassTitle>
  <acquiredDate>03/01/2025</acquiredDate>
  <natureOfAcquisitionTransaction>Restricted Stock Unit Grant</natureOfAcquisitionTransaction>
  <nameOfPersonfromWhomAcquired>Issuer</nameOfPersonfromWhomAcquired>
  <isGiftTransaction>N</isGiftTransaction>
  <amountOfSecuritiesAcquired>1187</amountOfSecuritiesAcquired>
  <paymentDate>03/01/2025</paymentDate>
  <natureOfPayment>Vesting of Restricted Stock Units</natureOfPayment>
  </securitiesToBeSold>
  <securitiesToBeSold>
  <securitiesClassTitle>Common Stock</securitiesClassTitle>
  <acquiredDate>03/01/2025</acquiredDate>
  <natureOfAcquisitionTransaction>Restricted Stock Unit Grant</natureOfAcquisitionTransaction>
  <nameOfPersonfromWhomAcquired>Issuer</nameOfPersonfromWhomAcquired>
  <isGiftTransaction>N</isGiftTransaction>
  <amountOfSecuritiesAcquired>774</amountOfSecuritiesAcquired>
  <paymentDate>03/01/2025</paymentDate>
  <natureOfPayment>Vesting of Restricted Stock Units</natureOfPayment>
  </securitiesToBeSold>
  <securitiesToBeSold>
  <securitiesClassTitle>Common Stock</securitiesClassTitle>
  <acquiredDate>03/01/2025</acquiredDate>
  <natureOfAcquisitionTransaction>Restricted Stock Unit Grant</natureOfAcquisitionTransaction>
  <nameOfPersonfromWhomAcquired>Issuer</nameOfPersonfromWhomAcquired>
  <isGiftTransaction>N</isGiftTransaction>
  <amountOfSecuritiesAcquired>258</amountOfSecuritiesAcquired>
  <paymentDate>03/01/2025</paymentDate>
  <natureOfPayment>Vesting of Restricted Stock Units</natureOfPayment>
  </securitiesToBeSold>
  <nothingToReportFlagOnSecuritiesSoldInPast3Months>Y</nothingToReportFlagOnSecuritiesSoldInPast3Months>
  <remarks>The sale of shares of common stock reported on this Form 144 represents (i) 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 and (ii) the sale of shares pursuant to a 10b5-1 Plan applicable to the Reporting Person. Aggregate Market Value of future sales is based on a closing price of $313.47 for the Issuer's Common Stock on March 3, 2025.</remarks>
  <noticeSignature>
  <noticeDate>03/03/2025</noticeDate>
  <planAdoptionDates>
  <planAdoptionDate>11/13/2024</planAdoptionDate>
  </planAdoptionDates>
  <signature>/s/Mardi Dier</signature>
  </noticeSignature>
  </formData>
  </edgarSubmission>
metadata_documents: [{"type": "144", "sequence": "1", "filename": "primary_doc.xml", "secsgml_size_bytes": 6085}]
text: 144
  0001574591
  XXXXXXXX
  LIVE
  0001157601
  Madrigal Pharmaceuticals, Inc.
  001-33277
  Four Towers Bridge
  200 Barr Harbor Drive, Suite 200
  West Conshohocken
  PA
  19428
  267-824-2827
  Mardi Dier
  Officer
  Common Stock
  Morgan Stanley Smith Barney LLC Executive Financial Services
  1 New York Plaza, 8th Floor
  New York
  NY
  10004
  1187
  386833.69
  22080246
  03/03/2025
  Nasdaq Stock Market
  Common Stock
  Morgan Stanley Smith Barney LLC Executive Financial Services
  1 New York Plaza, 8th Floor
  New York
  NY
  10004
  774
  250416.63
  22080246
  03/03/2025
  Nasdaq Stock Market
  Common Stock
  Morgan Stanley Smith Barney LLC Executive Financial Services
  1 New York Plaza, 8th Floor
  New York
  NY
  10004
  258
  80875.26
  22080246
  03/10/2025
  Nasdaq Stock Market
  Common Stock
  03/01/2025
  Restricted Stock Unit Grant
  Issuer
  N
  1187
  03/01/2025
  Vesting of Restricted Stock Units
  Common Stock
  03/01/2025
  Restricted Stock Unit Grant
  Issuer
  N
  774
  03/01/2025
  Vesting of Restricted Stock Units
  Common Stock
  03/01/2025
  Restricted Stock Unit Grant
  Issuer
  N
  258
  03/01/2025
  Vesting of Restricted Stock Units
  Y
  The sale of shares of common stock reported on this Form 144 represents (i) 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 and (ii) the sale of shares pursuant to a 10b5-1 Plan applicable to the Reporting Person. Aggregate Market Value of future sales is based on a closing price of $313.47 for the Issuer's Common Stock on March 3, 2025.
  03/03/2025
  11/13/2024
  /s/Mardi Dier