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        <lei>SQ95QG8SR5Q56LSNF682</lei>
        <title>Illumina Inc</title>
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          <isin value="US4523271090"/>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Nektar Therapeutics</name>
        <lei>5299005I24806IOIYE03</lei>
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        <cusip>640268108</cusip>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Gilead Sciences Inc</name>
        <lei>549300WTZWR07K8MNV44</lei>
        <title>Gilead Sciences Inc</title>
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          <isin value="US3755581036"/>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Alkermes PLC</name>
        <lei>N/A</lei>
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        <assetCat>EC</assetCat>
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        <invCountry>IE</invCountry>

        <isRestrictedSec>N</isRestrictedSec>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>FibroGen Inc</name>
        <lei>549300Q914ULWWY95822</lei>
        <title>FibroGen Inc</title>
        <cusip>31572Q808</cusip>
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          <isin value="US31572Q8087"/>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Ultragenyx Pharmaceutical Inc</name>
        <lei>529900EV44GVDN1DCX77</lei>
        <title>Ultragenyx Pharmaceutical Inc</title>
        <cusip>90400D108</cusip>
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          <isin value="US90400D1081"/>
          <ticker value="RARE"/>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Biogen Inc</name>
        <lei>W8J5WZB5IY3K0NDQT671</lei>
        <title>Biogen Inc</title>
        <cusip>09062X103</cusip>
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          <isin value="US09062X1037"/>
          <ticker value="BIIB"/>
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        <balance>230530.00000000</balance>
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        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        <isRestrictedSec>N</isRestrictedSec>
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          <isCashCollateral>N</isCashCollateral>
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          <isLoanByFund>N</isLoanByFund>
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      <invstOrSec>
        <name>Charles River Laboratories Int</name>
        <lei>549300BSQ0R4UZ5KX287</lei>
        <title>Charles River Laboratories International Inc</title>
        <cusip>159864107</cusip>
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          <isin value="US1598641074"/>
          <ticker value="CRL"/>
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        <balance>377605.00000000</balance>
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        <curCd>USD</curCd>
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        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        <isRestrictedSec>N</isRestrictedSec>
        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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          <isLoanByFund>N</isLoanByFund>
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      <invstOrSec>
        <name>QIAGEN NV</name>
        <lei>54930036WK3GMCN17Z57</lei>
        <title>QIAGEN NV</title>
        <cusip>000000000</cusip>
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          <isin value="NL0012169213"/>
          <ticker value="QGEN"/>
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        <balance>1780685.00000000</balance>
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        <curCd>USD</curCd>
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        <pctVal>3.342060695643</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>NL</invCountry>

        <isRestrictedSec>N</isRestrictedSec>
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
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      <invstOrSec>
        <name>Incyte Corp</name>
        <lei>549300Z4WN6JVZ3T4680</lei>
        <title>Incyte Corp</title>
        <cusip>45337C102</cusip>
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          <isin value="US45337C1027"/>
          <ticker value="INCY"/>
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        <balance>652349.00000000</balance>
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        <curCd>USD</curCd>
        <valUSD>56963114.68000000</valUSD>
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        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        <isRestrictedSec>N</isRestrictedSec>
        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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          <isLoanByFund>N</isLoanByFund>
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      <invstOrSec>
        <name>Agios Pharmaceuticals Inc</name>
        <lei>529900ONJHY8EOGYT555</lei>
        <title>Agios Pharmaceuticals Inc</title>
        <cusip>00847X104</cusip>
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          <isin value="US00847X1046"/>
          <ticker value="AGIO"/>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>
        <isRestrictedSec>N</isRestrictedSec>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>BioMarin Pharmaceutical Inc</name>
        <lei>NSLL8ITTRR0J5HEMR848</lei>
        <title>BioMarin Pharmaceutical Inc</title>
        <cusip>09061G101</cusip>
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          <isin value="US09061G1013"/>
          <ticker value="BMRN"/>
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        <balance>733841.00000000</balance>
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        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        <isRestrictedSec>N</isRestrictedSec>
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
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          <isLoanByFund>N</isLoanByFund>
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      <invstOrSec>
        <name>Exact Sciences Corp</name>
        <lei>549300VM3X1FYD4N9Z14</lei>
        <title>Exact Sciences Corp</title>
        <cusip>30063P105</cusip>
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          <isin value="US30063P1057"/>
          <ticker value="EXAS"/>
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        <balance>525661.00000000</balance>
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        <curCd>USD</curCd>
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        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        <isRestrictedSec>N</isRestrictedSec>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Grifols SA</name>
        <lei>959800HSSNXWRKBK4N60</lei>
        <title>Grifols SA</title>
        <cusip>398438408</cusip>
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          <isin value="US3984384087"/>
          <ticker value="GRFS"/>
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        <balance>2438997.00000000</balance>
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        <curCd>USD</curCd>
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        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>ES</invCountry>
        <isRestrictedSec>N</isRestrictedSec>
        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Ionis Pharmaceuticals Inc</name>
        <lei>549300SI4ZGLG0BLUZ92</lei>
        <title>Ionis Pharmaceuticals Inc</title>
        <cusip>462222100</cusip>
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          <isin value="US4622221004"/>
          <ticker value="IONS"/>
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        <balance>909223.00000000</balance>
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        <valUSD>54926161.43000000</valUSD>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>
        <isRestrictedSec>N</isRestrictedSec>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Alexion Pharmaceuticals Inc</name>
        <lei>M1YXUUZR0EIMU8T0EM75</lei>
        <title>Alexion Pharmaceuticals Inc</title>
        <cusip>015351109</cusip>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>
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        <name>Neurocrine Biosciences Inc</name>
        <lei>549300FECER0XBN49756</lei>
        <title>Neurocrine Biosciences Inc</title>
        <cusip>64125C109</cusip>
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          <ticker value="NBIX"/>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>
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        <name>Seattle Genetics Inc</name>
        <lei>N/A</lei>
        <title>Seattle Genetics Inc</title>
        <cusip>812578102</cusip>
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        <invCountry>US</invCountry>
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        <name>ACADIA PHARMACEUTICALS INC</name>
        <lei>529900O3044NO0PEA039</lei>
        <title>ACADIA PHARMACEUTICALS INC</title>
        <cusip>004225108</cusip>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>
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        <name>Exelixis Inc</name>
        <lei>N/A</lei>
        <title>Exelixis Inc</title>
        <cusip>30161Q104</cusip>
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        <invCountry>US</invCountry>
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          <isCashCollateral>N</isCashCollateral>
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        <name>Regeneron Pharmaceuticals Inc</name>
        <lei>549300RCBFWIRX3HYQ56</lei>
        <title>Regeneron Pharmaceuticals Inc</title>
        <cusip>75886F107</cusip>
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          <ticker value="REGN"/>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Intercept Pharmaceuticals Inc</name>
        <lei>N/A</lei>
        <title>Intercept Pharmaceuticals Inc</title>
        <cusip>45845P108</cusip>
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          <ticker value="ICPT"/>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>
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      <invstOrSec>
        <name>Amgen Inc</name>
        <lei>62QBXGPJ34PQ72Z12S66</lei>
        <title>Amgen Inc</title>
        <cusip>031162100</cusip>
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          <isin value="US0311621009"/>
          <ticker value="AMGN"/>
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        <balance>250405.00000000</balance>
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        <curCd>USD</curCd>
        <valUSD>60365133.35000000</valUSD>
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        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>
        <isRestrictedSec>N</isRestrictedSec>
        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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          <isLoanByFund>N</isLoanByFund>
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        <name>IQVIA Holdings Inc</name>
        <lei>549300W3R20NM4KQPH86</lei>
        <title>IQVIA Holdings Inc</title>
        <cusip>46266C105</cusip>
        <identifiers>
          <isin value="US46266C1053"/>
          <ticker value="IQV"/>
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        <balance>353749.00000000</balance>
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        <curCd>USD</curCd>
        <valUSD>54657757.99000000</valUSD>
        <pctVal>3.035025509353</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>
        <isRestrictedSec>N</isRestrictedSec>
        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
    </invstOrSecs>
    <explntrNotes>
      <explntrNote note="Monthly returns presented in Item B.5(a) have been calculated without deducting any applicable sales loads or redemption fees." noteItem="B.5.a"/>
    </explntrNotes>
    <signature>
      <ncom:dateSigned>2020-02-24</ncom:dateSigned>
      <ncom:nameOfApplicant>First Trust Exchange-Traded Fund</ncom:nameOfApplicant>
      <ncom:signature>Donald P. Swade</ncom:signature>
      <ncom:signerName>Donald P. Swade</ncom:signerName>
      <ncom:title>Treasurer, Chief Financial Officer and Chief Accounting Officer</ncom:title>
    </signature>
  </formData>
</edgarSubmission>
