United States securities and exchange commission logo

                           November 19, 2021

       Joseph Oliveto
       Chief Executive Officer
       Milestone Pharmaceuticals Inc.
       7422 Carmel Executive Park Drive, Suite 300
       Charlotte, NC 28226

                                                        Re: Milestone
Pharmaceuticals Inc.
Statement on Form S-3
                                                            Filed November 12,
                                                            File No. 333-261049

       Dear Mr. Oliveto:

              This is to advise you that we have not reviewed and will not
review your registration

               Please refer to Rules 460 and 461 regarding requests for
acceleration. We remind you
       that the company and its management are responsible for the accuracy and
adequacy of their
       disclosures, notwithstanding any review, comments, action or absence of
action by the staff.

                                                        Please contact Jeffrey
Gabor at 202-551-2544 with any questions.


                           Division of Corporation Finance

                           Office of Life Sciences
       cc:                                              Ryan S. Sansom, Esq.