<?xml version="1.0" encoding="UTF-8"?><own:edgarSubmission xmlns:com="http://www.sec.gov/edgar/common" xmlns:own="http://www.sec.gov/edgar/ownership">
  <!-- Generated by Workiva -->
  <own:headerData>
    <own:submissionType>144</own:submissionType>
    <own:filerInfo>
      <own:filer>
        <own:filerCredentials>
          <own:cik>0001200612</own:cik>
          <own:ccc>XXXXXXXX</own:ccc>
        </own:filerCredentials>
      </own:filer>
      <own:liveTestFlag>LIVE</own:liveTestFlag>



    </own:filerInfo>
  </own:headerData>
  <own:formData>
    <own:issuerInfo>
      <own:issuerCik>0001027838</own:issuerCik>
      <own:issuerName>Tactile Systems Technology Inc</own:issuerName>
      <own:secFileNumber>001-37799</own:secFileNumber>
      <own:issuerAddress>
        <com:street1>3701 Wayzata Blvd Ste 300</com:street1>
        <com:city>Minneapolis</com:city>
        <com:stateOrCountry>MN</com:stateOrCountry>
        <com:zipCode>55416</com:zipCode>
      </own:issuerAddress>
      <own:issuerContactPhone>6124514149</own:issuerContactPhone>
      <own:nameOfPersonForWhoseAccountTheSecuritiesAreToBeSold>William W Burke</own:nameOfPersonForWhoseAccountTheSecuritiesAreToBeSold>
      <own:relationshipsToIssuer>
        <own:relationshipToIssuer>board of director</own:relationshipToIssuer>
      </own:relationshipsToIssuer>
    </own:issuerInfo>
    <own:securitiesInformation>
      <own:securitiesClassTitle>Common</own:securitiesClassTitle>
      <own:brokerOrMarketmakerDetails>
        <own:name>Merrill Lynch</own:name>
        <own:address>
          <com:street1>300 Crescent Ct Suite 1300</com:street1>
          <com:city>Dallas</com:city>
          <com:stateOrCountry>TX</com:stateOrCountry>
          <com:zipCode>75223</com:zipCode>
        </own:address>
      </own:brokerOrMarketmakerDetails>
      <own:noOfUnitsSold>15000</own:noOfUnitsSold>
      <own:aggregateMarketValue>540260000</own:aggregateMarketValue>
      <own:noOfUnitsOutstanding>22650000</own:noOfUnitsOutstanding>
      <own:approxSaleDate>08/19/2026</own:approxSaleDate>
      <own:securitiesExchangeName>NASDAQ</own:securitiesExchangeName>
    </own:securitiesInformation>
    <own:securitiesToBeSold>
      <own:securitiesClassTitle>Common</own:securitiesClassTitle>
      <own:acquiredDate>05/11/2026</own:acquiredDate>
      <own:natureOfAcquisitionTransaction>Restricted</own:natureOfAcquisitionTransaction>
      <own:nameOfPersonfromWhomAcquired>Issuer</own:nameOfPersonfromWhomAcquired>
      <own:isGiftTransaction>N</own:isGiftTransaction>
      <own:amountOfSecuritiesAcquired>11255</own:amountOfSecuritiesAcquired>
      <own:paymentDate>05/11/2026</own:paymentDate>
      <own:natureOfPayment>Restricted</own:natureOfPayment>
    </own:securitiesToBeSold>
    <own:nothingToReportFlagOnSecuritiesSoldInPast3Months>Y</own:nothingToReportFlagOnSecuritiesSoldInPast3Months>
    <own:remarks>Billy Corbellini</own:remarks>
    <own:noticeSignature>
      <own:noticeDate>08/19/2026</own:noticeDate>
      <own:planAdoptionDates>
        <own:planAdoptionDate>05/15/2026</own:planAdoptionDate>
      </own:planAdoptionDates>
      <own:signature>Billy Corbellini</own:signature>
    </own:noticeSignature>
  </own:formData>
</own:edgarSubmission>
