Statement of Changes in Beneficial Ownership (Form 4)

FORM 4 Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.

UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940

OMB APPROVAL OMB Number: 3235-0287 Estimated average burden hours per response... 0.5

(Print or Type Responses)

1. Name and Address of Reporting Person * Sibold William John 2. Issuer Name and Ticker or Trading Symbol MADRIGAL PHARMACEUTICALS, INC. [MDGL] 5. Relationship of Reporting Person(s) to Issuer (Check all applicable) __X__ Director _____ 10% Owner __X__ Officer (give title below) _____ Other (specify below) President and CEO (Last) (First) (Middle) C/O MADRIGAL PHARMACEUTICALS, INC., 200 BARR HARBOR DRIVE, SUITE 200 3. Date of Earliest Transaction (Month/Day/Year) 12/03/2025 (Street) WEST CONSHOHOCKEN, PA 19428 4. If Amendment, Date Original Filed (Month/Day/Year) 6. Individual or Joint/Group Filing (Check Applicable Line) _X_ Form filed by One Reporting Person ___ Form filed by More than One Reporting Person (City) (State) (Zip) Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned

1.Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4) Code V Amount (A) or (D) Price Common Stock 12/03/2025 M(1) 50,000 A (1) 152,474 D Common Stock 12/04/2025 S(2) 2,400 D $575.34 150,074 D

Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
	Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number.		SEC 1474 (9-02)

Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)

1. Title of Derivative Security (Instr. 3)

2. Conversion or Exercise Price of Derivative Security

3. Transaction Date (Month/Day/Year)

3A. Deemed Execution Date, if any (Month/Day/Year)

4. Transaction Code (Instr. 8)

5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4, and 5)

6. Date Exercisable and Expiration Date (Month/Day/Year)

7. Title and Amount of Underlying Securities (Instr. 3 and 4)

8. Price of Derivative Security (Instr. 5)

9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)

10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4)

11. Nature of Indirect Beneficial Ownership (Instr. 4)

Code

V

(A)

(D)

Date Exercisable

Expiration Date

Title

Amount or Number of Shares

Performance Restricted Stock Units

(3)

12/03/2025

M

50,000

(3)

(3)

Common Stock

50,000

(3)

0 (3)

D

Reporting Owners

Reporting Owner Name / Address	Relationships
	Director	10% Owner	Officer	Other
Sibold William John C/O MADRIGAL PHARMACEUTICALS, INC. 200 BARR HARBOR DRIVE, SUITE 200 WEST CONSHOHOCKEN, PA 19428	X		President and CEO

Signatures

/s/ Mardi Dier, as Attorney-in-Fact		12/04/2025
**Signature of Reporting Person		Date

Explanation of Responses:

*	If the form is filed by more than one reporting person, see Instruction 4(b)(v).
**	Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
(1)	On December 3, 2025, the Reporting Person earned 50,000 shares of common stock following the achievement of the performance and service conditions of the Performance Restricted Stock Units described in Footnote 3. Pursuant to the terms of the award, certain of these shares were sold to cover certain tax withholding obligations as described in Footnote 2 below. The Issuer is irrevocably obligated to issue the remaining shares to the Reporting Person on September 8, 2028, the fifth anniversary of the commencement of his employment with the Issuer.
(2)	The sale reported on this line represents the number of shares sold by the Issuer on behalf of the Reporting Person to cover certain tax withholding obligations in connection with the Reporting Person earning 50,000 shares of common stock as described in Footnote 1 above. This sale was automatic and not at the discretion of the Reporting Person.
(3)	On September 11, 2023, the Reporting Person was granted a one-time sign-on award of Performance Restricted Stock Units with a target award of 50,000 shares of common stock that can be earned upon the achievement of significant sustained stock price appreciation hurdles over a five-year period. The Reporting Person can earn up to 300% of the target award. Following the achievement of the first hurdle in February 2025 and the second hurdle reported on this line, the Reporting Person is eligible to earn an additional 50,000 shares upon the achievement of the final performance hurdle. See the Issuer's Schedule 14A filed with the Securities and Exchange Commission on April 29, 2024 for additional information about the Performance Restricted Stock Units.

Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB number.