<?xml version="1.0" encoding="UTF-8"?><ns2:edgarSubmission xmlns:com="http://www.sec.gov/edgar/common" xmlns:ns2="http://www.sec.gov/edgar/ownership">
    <ns2:headerData>
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        <ns2:filerInfo>
            <ns2:filer>
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                    <ns2:cik>0001236397</ns2:cik>
                    <ns2:ccc>XXXXXXXX</ns2:ccc>
                </ns2:filerCredentials>
            </ns2:filer>
            <ns2:liveTestFlag>LIVE</ns2:liveTestFlag>



        </ns2:filerInfo>
    </ns2:headerData>
    <ns2:formData>
        <ns2:issuerInfo>
            <ns2:issuerCik>0001447362</ns2:issuerCik>
            <ns2:issuerName>Castle Biosciences, Inc.</ns2:issuerName>
            <ns2:secFileNumber>001-38984</ns2:secFileNumber>
            <ns2:issuerAddress>
                <com:street1>505 S FRIENDSWOOD DR</com:street1>
                <com:street2>SUITE 401</com:street2>
                <com:city>FRIENDSWOOD</com:city>
                <com:stateOrCountry>TX</com:stateOrCountry>
                <com:zipCode>77546</com:zipCode>
            </ns2:issuerAddress>
            <ns2:issuerContactPhone>1-866-788-9007</ns2:issuerContactPhone>
            <ns2:nameOfPersonForWhoseAccountTheSecuritiesAreToBeSold>Daniel Bradbury</ns2:nameOfPersonForWhoseAccountTheSecuritiesAreToBeSold>
            <ns2:relationshipsToIssuer>
                <ns2:relationshipToIssuer>Other: Affiliate</ns2:relationshipToIssuer>
            </ns2:relationshipsToIssuer>
        </ns2:issuerInfo>
        <ns2:securitiesInformation>
            <ns2:securitiesClassTitle>Common</ns2:securitiesClassTitle>
            <ns2:brokerOrMarketmakerDetails>
                <ns2:name>Goldman Sachs &amp; Co. LLC</ns2:name>
                <ns2:address>
                    <com:street1>200 West Street</com:street1>
                    <com:city>New York</com:city>
                    <com:stateOrCountry>NY</com:stateOrCountry>
                    <com:zipCode>10282</com:zipCode>
                </ns2:address>
            </ns2:brokerOrMarketmakerDetails>
            <ns2:noOfUnitsSold>86280</ns2:noOfUnitsSold>
            <ns2:aggregateMarketValue>1730776.8</ns2:aggregateMarketValue>
            <ns2:noOfUnitsOutstanding>26910548</ns2:noOfUnitsOutstanding>
            <ns2:approxSaleDate>11/20/2023</ns2:approxSaleDate>
            <ns2:securitiesExchangeName>NASD</ns2:securitiesExchangeName>
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            <ns2:securitiesClassTitle>Common</ns2:securitiesClassTitle>
            <ns2:acquiredDate>01/03/2018</ns2:acquiredDate>
            <ns2:natureOfAcquisitionTransaction>Private Transaction</ns2:natureOfAcquisitionTransaction>
            <ns2:nameOfPersonfromWhomAcquired>Issuer</ns2:nameOfPersonfromWhomAcquired>
            <ns2:isGiftTransaction>N</ns2:isGiftTransaction>
            <ns2:amountOfSecuritiesAcquired>44887</ns2:amountOfSecuritiesAcquired>
            <ns2:paymentDate>01/03/2018</ns2:paymentDate>
            <ns2:natureOfPayment>N/A</ns2:natureOfPayment>
        </ns2:securitiesToBeSold>
        <ns2:securitiesToBeSold>
            <ns2:securitiesClassTitle>Common</ns2:securitiesClassTitle>
            <ns2:acquiredDate>06/08/2018</ns2:acquiredDate>
            <ns2:natureOfAcquisitionTransaction>Private Transaction</ns2:natureOfAcquisitionTransaction>
            <ns2:nameOfPersonfromWhomAcquired>Issuer</ns2:nameOfPersonfromWhomAcquired>
            <ns2:isGiftTransaction>N</ns2:isGiftTransaction>
            <ns2:amountOfSecuritiesAcquired>6879</ns2:amountOfSecuritiesAcquired>
            <ns2:paymentDate>06/08/2018</ns2:paymentDate>
            <ns2:natureOfPayment>N/A</ns2:natureOfPayment>
        </ns2:securitiesToBeSold>
        <ns2:securitiesToBeSold>
            <ns2:securitiesClassTitle>Common</ns2:securitiesClassTitle>
            <ns2:acquiredDate>03/09/2009</ns2:acquiredDate>
            <ns2:natureOfAcquisitionTransaction>Stock Gift</ns2:natureOfAcquisitionTransaction>
            <ns2:nameOfPersonfromWhomAcquired>Daniel Bradbury</ns2:nameOfPersonfromWhomAcquired>
            <ns2:isGiftTransaction>Y</ns2:isGiftTransaction>
            <ns2:donarAcquiredDate>08/12/2014</ns2:donarAcquiredDate>
            <ns2:amountOfSecuritiesAcquired>7004</ns2:amountOfSecuritiesAcquired>
            <ns2:paymentDate>12/08/2020</ns2:paymentDate>
            <ns2:natureOfPayment>N/A</ns2:natureOfPayment>
        </ns2:securitiesToBeSold>
        <ns2:securitiesToBeSold>
            <ns2:securitiesClassTitle>Common</ns2:securitiesClassTitle>
            <ns2:acquiredDate>09/12/2008</ns2:acquiredDate>
            <ns2:natureOfAcquisitionTransaction>Stock Gift</ns2:natureOfAcquisitionTransaction>
            <ns2:nameOfPersonfromWhomAcquired>Daniel Bradbury</ns2:nameOfPersonfromWhomAcquired>
            <ns2:isGiftTransaction>Y</ns2:isGiftTransaction>
            <ns2:donarAcquiredDate>08/12/2014</ns2:donarAcquiredDate>
            <ns2:amountOfSecuritiesAcquired>10253</ns2:amountOfSecuritiesAcquired>
            <ns2:paymentDate>12/08/2020</ns2:paymentDate>
            <ns2:natureOfPayment>N/A</ns2:natureOfPayment>
        </ns2:securitiesToBeSold>
        <ns2:securitiesToBeSold>
            <ns2:securitiesClassTitle>Common</ns2:securitiesClassTitle>
            <ns2:acquiredDate>03/09/2009</ns2:acquiredDate>
            <ns2:natureOfAcquisitionTransaction>Stock Gift</ns2:natureOfAcquisitionTransaction>
            <ns2:nameOfPersonfromWhomAcquired>Daniel Bradbury</ns2:nameOfPersonfromWhomAcquired>
            <ns2:isGiftTransaction>Y</ns2:isGiftTransaction>
            <ns2:donarAcquiredDate>08/12/2014</ns2:donarAcquiredDate>
            <ns2:amountOfSecuritiesAcquired>6985</ns2:amountOfSecuritiesAcquired>
            <ns2:paymentDate>12/08/2020</ns2:paymentDate>
            <ns2:natureOfPayment>N/A</ns2:natureOfPayment>
        </ns2:securitiesToBeSold>
        <ns2:securitiesToBeSold>
            <ns2:securitiesClassTitle>Common</ns2:securitiesClassTitle>
            <ns2:acquiredDate>09/12/2008</ns2:acquiredDate>
            <ns2:natureOfAcquisitionTransaction>Stock Gift</ns2:natureOfAcquisitionTransaction>
            <ns2:nameOfPersonfromWhomAcquired>Daniel Bradbury</ns2:nameOfPersonfromWhomAcquired>
            <ns2:isGiftTransaction>Y</ns2:isGiftTransaction>
            <ns2:donarAcquiredDate>08/12/2014</ns2:donarAcquiredDate>
            <ns2:amountOfSecuritiesAcquired>10272</ns2:amountOfSecuritiesAcquired>
            <ns2:paymentDate>12/08/2020</ns2:paymentDate>
            <ns2:natureOfPayment>N/A</ns2:natureOfPayment>
        </ns2:securitiesToBeSold>
        <ns2:nothingToReportFlagOnSecuritiesSoldInPast3Months>N</ns2:nothingToReportFlagOnSecuritiesSoldInPast3Months>
        <ns2:securitiesSoldInPast3Months>
            <ns2:sellerDetails>
                <ns2:name>The Daniel M. Bradbury Irrevocable Descendants Trust</ns2:name>
                <ns2:address>
                    <com:street1>505 S FRIENDSWOOD DR</com:street1>
                    <com:street2>SUITE 401</com:street2>
                    <com:city>FRIENDSWOOD</com:city>
                    <com:stateOrCountry>TX</com:stateOrCountry>
                    <com:zipCode>77546</com:zipCode>
                </ns2:address>
            </ns2:sellerDetails>
            <ns2:securitiesClassTitle>Common</ns2:securitiesClassTitle>
            <ns2:saleDate>08/30/2023</ns2:saleDate>
            <ns2:amountOfSecuritiesSold>926</ns2:amountOfSecuritiesSold>
            <ns2:grossProceeds>18547.78</ns2:grossProceeds>
        </ns2:securitiesSoldInPast3Months>
        <ns2:securitiesSoldInPast3Months>
            <ns2:sellerDetails>
                <ns2:name>The Annette E. Bradbury Irrevocable Descendants Trust</ns2:name>
                <ns2:address>
                    <com:street1>505 S FRIENDSWOOD DR</com:street1>
                    <com:street2>SUITE 401</com:street2>
                    <com:city>FRIENDSWOOD</com:city>
                    <com:stateOrCountry>TX</com:stateOrCountry>
                    <com:zipCode>77546</com:zipCode>
                </ns2:address>
            </ns2:sellerDetails>
            <ns2:securitiesClassTitle>Common</ns2:securitiesClassTitle>
            <ns2:saleDate>08/30/2023</ns2:saleDate>
            <ns2:amountOfSecuritiesSold>926</ns2:amountOfSecuritiesSold>
            <ns2:grossProceeds>18547.78</ns2:grossProceeds>
        </ns2:securitiesSoldInPast3Months>
        <ns2:securitiesSoldInPast3Months>
            <ns2:sellerDetails>
                <ns2:name>BioBrit, LLC</ns2:name>
                <ns2:address>
                    <com:street1>505 S FRIENDSWOOD DR</com:street1>
                    <com:street2>SUITE 401</com:street2>
                    <com:city>FRIENDSWOOD</com:city>
                    <com:stateOrCountry>TX</com:stateOrCountry>
                    <com:zipCode>77546</com:zipCode>
                </ns2:address>
            </ns2:sellerDetails>
            <ns2:securitiesClassTitle>Common</ns2:securitiesClassTitle>
            <ns2:saleDate>08/30/2023</ns2:saleDate>
            <ns2:amountOfSecuritiesSold>2780</ns2:amountOfSecuritiesSold>
            <ns2:grossProceeds>55683.4</ns2:grossProceeds>
        </ns2:securitiesSoldInPast3Months>
        <ns2:securitiesSoldInPast3Months>
            <ns2:sellerDetails>
                <ns2:name>The Daniel M. Bradbury Irrevocable Descendants Trust</ns2:name>
                <ns2:address>
                    <com:street1>505 S FRIENDSWOOD DR</com:street1>
                    <com:street2>SUITE 401</com:street2>
                    <com:city>FRIENDSWOOD</com:city>
                    <com:stateOrCountry>TX</com:stateOrCountry>
                    <com:zipCode>77546</com:zipCode>
                </ns2:address>
            </ns2:sellerDetails>
            <ns2:securitiesClassTitle>Common</ns2:securitiesClassTitle>
            <ns2:saleDate>08/31/2023</ns2:saleDate>
            <ns2:amountOfSecuritiesSold>1457</ns2:amountOfSecuritiesSold>
            <ns2:grossProceeds>29216.93</ns2:grossProceeds>
        </ns2:securitiesSoldInPast3Months>
        <ns2:securitiesSoldInPast3Months>
            <ns2:sellerDetails>
                <ns2:name>The Annette E. Bradbury Irrevocable Descendants Trust</ns2:name>
                <ns2:address>
                    <com:street1>505 S FRIENDSWOOD DR</com:street1>
                    <com:street2>SUITE 401</com:street2>
                    <com:city>FRIENDSWOOD</com:city>
                    <com:stateOrCountry>TX</com:stateOrCountry>
                    <com:zipCode>77546</com:zipCode>
                </ns2:address>
            </ns2:sellerDetails>
            <ns2:securitiesClassTitle>Common</ns2:securitiesClassTitle>
            <ns2:saleDate>08/31/2023</ns2:saleDate>
            <ns2:amountOfSecuritiesSold>1457</ns2:amountOfSecuritiesSold>
            <ns2:grossProceeds>29216.93</ns2:grossProceeds>
        </ns2:securitiesSoldInPast3Months>
        <ns2:securitiesSoldInPast3Months>
            <ns2:sellerDetails>
                <ns2:name>BioBrit, LLC</ns2:name>
                <ns2:address>
                    <com:street1>505 S FRIENDSWOOD DR</com:street1>
                    <com:street2>SUITE 401</com:street2>
                    <com:city>FRIENDSWOOD</com:city>
                    <com:stateOrCountry>TX</com:stateOrCountry>
                    <com:zipCode>77546</com:zipCode>
                </ns2:address>
            </ns2:sellerDetails>
            <ns2:securitiesClassTitle>Common</ns2:securitiesClassTitle>
            <ns2:saleDate>08/31/2023</ns2:saleDate>
            <ns2:amountOfSecuritiesSold>4372</ns2:amountOfSecuritiesSold>
            <ns2:grossProceeds>87670.84</ns2:grossProceeds>
        </ns2:securitiesSoldInPast3Months>
        <ns2:securitiesSoldInPast3Months>
            <ns2:sellerDetails>
                <ns2:name>The Daniel M. Bradbury Irrevocable Descendants Trust</ns2:name>
                <ns2:address>
                    <com:street1>505 S FRIENDSWOOD DR</com:street1>
                    <com:street2>SUITE 401</com:street2>
                    <com:city>FRIENDSWOOD</com:city>
                    <com:stateOrCountry>TX</com:stateOrCountry>
                    <com:zipCode>77546</com:zipCode>
                </ns2:address>
            </ns2:sellerDetails>
            <ns2:securitiesClassTitle>Common</ns2:securitiesClassTitle>
            <ns2:saleDate>09/01/2023</ns2:saleDate>
            <ns2:amountOfSecuritiesSold>360</ns2:amountOfSecuritiesSold>
            <ns2:grossProceeds>7215.05</ns2:grossProceeds>
        </ns2:securitiesSoldInPast3Months>
        <ns2:securitiesSoldInPast3Months>
            <ns2:sellerDetails>
                <ns2:name>The Annette E. Bradbury Irrevocable Descendants Trust</ns2:name>
                <ns2:address>
                    <com:street1>505 S FRIENDSWOOD DR</com:street1>
                    <com:street2>SUITE 401</com:street2>
                    <com:city>FRIENDSWOOD</com:city>
                    <com:stateOrCountry>TX</com:stateOrCountry>
                    <com:zipCode>77546</com:zipCode>
                </ns2:address>
            </ns2:sellerDetails>
            <ns2:securitiesClassTitle>Common</ns2:securitiesClassTitle>
            <ns2:saleDate>09/01/2023</ns2:saleDate>
            <ns2:amountOfSecuritiesSold>360</ns2:amountOfSecuritiesSold>
            <ns2:grossProceeds>7215.05</ns2:grossProceeds>
        </ns2:securitiesSoldInPast3Months>
        <ns2:securitiesSoldInPast3Months>
            <ns2:sellerDetails>
                <ns2:name>BioBrit, LLC</ns2:name>
                <ns2:address>
                    <com:street1>505 S FRIENDSWOOD DR</com:street1>
                    <com:street2>SUITE 401</com:street2>
                    <com:city>FRIENDSWOOD</com:city>
                    <com:stateOrCountry>TX</com:stateOrCountry>
                    <com:zipCode>77546</com:zipCode>
                </ns2:address>
            </ns2:sellerDetails>
            <ns2:securitiesClassTitle>Common</ns2:securitiesClassTitle>
            <ns2:saleDate>09/01/2023</ns2:saleDate>
            <ns2:amountOfSecuritiesSold>1082</ns2:amountOfSecuritiesSold>
            <ns2:grossProceeds>21685.23</ns2:grossProceeds>
        </ns2:securitiesSoldInPast3Months>
        <ns2:remarks>Total number of shares to be sold includes 51,766 shares by BioBrit, LLC, 17,257 shares by The Daniel M. Bradbury Irrevocable Descendants Trust, 17,257 shares by The Annette E. Bradbury Irrevocable Descendants Trust. The sales set forth herein are made in connection with a selling plan dated 11/23/2022, that is intended to comply with Rule 105-1 (c).</ns2:remarks>
        <ns2:noticeSignature>
            <ns2:noticeDate>11/20/2023</ns2:noticeDate>
            <ns2:planAdoptionDates>
                <ns2:planAdoptionDate>11/23/2022</ns2:planAdoptionDate>
            </ns2:planAdoptionDates>
            <ns2:signature>Goldman Sachs &amp; Co. LLC on behalf of Daniel Bradbury</ns2:signature>
        </ns2:noticeSignature>
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144
0001236397
XXXXXXXX
LIVE
0001447362
Castle Biosciences, Inc.
001-38984
505 S FRIENDSWOOD DR
SUITE 401
FRIENDSWOOD
TX
77546
1-866-788-9007
Daniel Bradbury
Other: Affiliate
Common
Goldman Sachs & Co. LLC
200 West Street
New York
NY
10282
86280
1730776.8
26910548
11/20/2023
NASD
Common
01/03/2018
Private Transaction
Issuer
N
44887
01/03/2018
N/A
Common
06/08/2018
Private Transaction
Issuer
N
6879
06/08/2018
N/A
Common
03/09/2009
Stock Gift
Daniel Bradbury
Y
08/12/2014
7004
12/08/2020
N/A
Common
09/12/2008
Stock Gift
Daniel Bradbury
Y
08/12/2014
10253
12/08/2020
N/A
Common
03/09/2009
Stock Gift
Daniel Bradbury
Y
08/12/2014
6985
12/08/2020
N/A
Common
09/12/2008
Stock Gift
Daniel Bradbury
Y
08/12/2014
10272
12/08/2020
N/A
N
The Daniel M. Bradbury Irrevocable Descendants Trust
505 S FRIENDSWOOD DR
SUITE 401
FRIENDSWOOD
TX
77546
Common
08/30/2023
926
18547.78
The Annette E. Bradbury Irrevocable Descendants Trust
505 S FRIENDSWOOD DR
SUITE 401
FRIENDSWOOD
TX
77546
Common
08/30/2023
926
18547.78
BioBrit, LLC
505 S FRIENDSWOOD DR
SUITE 401
FRIENDSWOOD
TX
77546
Common
08/30/2023
2780
55683.4
The Daniel M. Bradbury Irrevocable Descendants Trust
505 S FRIENDSWOOD DR
SUITE 401
FRIENDSWOOD
TX
77546
Common
08/31/2023
1457
29216.93
The Annette E. Bradbury Irrevocable Descendants Trust
505 S FRIENDSWOOD DR
SUITE 401
FRIENDSWOOD
TX
77546
Common
08/31/2023
1457
29216.93
BioBrit, LLC
505 S FRIENDSWOOD DR
SUITE 401
FRIENDSWOOD
TX
77546
Common
08/31/2023
4372
87670.84
The Daniel M. Bradbury Irrevocable Descendants Trust
505 S FRIENDSWOOD DR
SUITE 401
FRIENDSWOOD
TX
77546
Common
09/01/2023
360
7215.05
The Annette E. Bradbury Irrevocable Descendants Trust
505 S FRIENDSWOOD DR
SUITE 401
FRIENDSWOOD
TX
77546
Common
09/01/2023
360
7215.05
BioBrit, LLC
505 S FRIENDSWOOD DR
SUITE 401
FRIENDSWOOD
TX
77546
Common
09/01/2023
1082
21685.23
Total number of shares to be sold includes 51,766 shares by BioBrit, LLC, 17,257 shares by The Daniel M. Bradbury Irrevocable Descendants Trust, 17,257 shares by The Annette E. Bradbury Irrevocable Descendants Trust. The sales set forth herein are made in connection with a selling plan dated 11/23/2022, that is intended to comply with Rule 105-1 (c).
11/20/2023
11/23/2022
Goldman Sachs & Co. LLC on behalf of Daniel Bradbury