<?xml version="1.0"?>
<ownershipDocument>

    <schemaVersion>X0303</schemaVersion>

    <documentType>4</documentType>

    <periodOfReport>2009-05-07</periodOfReport>

    <issuer>
        <issuerCik>0001344413</issuerCik>
        <issuerName>Alexza Pharmaceuticals Inc.</issuerName>
        <issuerTradingSymbol>ALXA</issuerTradingSymbol>
    </issuer>

    <reportingOwner>
        <reportingOwnerId>
            <rptOwnerCik>0001201580</rptOwnerCik>
            <rptOwnerName>COLELLA SAMUEL D</rptOwnerName>
        </reportingOwnerId>
        <reportingOwnerAddress>
            <rptOwnerStreet1>VERSANT VENTURES</rptOwnerStreet1>
            <rptOwnerStreet2>3000 SAND HILL ROAD, BLDG FOUR, STE 210</rptOwnerStreet2>
            <rptOwnerCity>MENLO PARK</rptOwnerCity>
            <rptOwnerState>CA</rptOwnerState>
            <rptOwnerZipCode>94025</rptOwnerZipCode>
            <rptOwnerStateDescription></rptOwnerStateDescription>
        </reportingOwnerAddress>
        <reportingOwnerRelationship>
            <isDirector>1</isDirector>
            <isOfficer>0</isOfficer>
            <isTenPercentOwner>0</isTenPercentOwner>
            <isOther>0</isOther>
        </reportingOwnerRelationship>
    </reportingOwner>

    <nonDerivativeTable></nonDerivativeTable>

    <derivativeTable>
        <derivativeTransaction>
            <securityTitle>
                <value>Stock Option (right to buy)</value>
            </securityTitle>
            <conversionOrExercisePrice>
                <value>1.69</value>
            </conversionOrExercisePrice>
            <transactionDate>
                <value>2009-05-07</value>
            </transactionDate>
            <transactionCoding>
                <transactionFormType>4</transactionFormType>
                <transactionCode>A</transactionCode>
                <equitySwapInvolved>0</equitySwapInvolved>
            </transactionCoding>
            <transactionAmounts>
                <transactionShares>
                    <value>6250</value>
                </transactionShares>
                <transactionPricePerShare>
                    <value>0</value>
                </transactionPricePerShare>
                <transactionAcquiredDisposedCode>
                    <value>A</value>
                </transactionAcquiredDisposedCode>
            </transactionAmounts>
            <exerciseDate>
                <value>2009-06-07</value>
                <footnoteId id="F1"/>
            </exerciseDate>
            <expirationDate>
                <value>2019-05-07</value>
            </expirationDate>
            <underlyingSecurity>
                <underlyingSecurityTitle>
                    <value>Common Stock</value>
                </underlyingSecurityTitle>
                <underlyingSecurityShares>
                    <value>6250</value>
                </underlyingSecurityShares>
            </underlyingSecurity>
            <postTransactionAmounts>
                <sharesOwnedFollowingTransaction>
                    <value>6250</value>
                </sharesOwnedFollowingTransaction>
            </postTransactionAmounts>
            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>D</value>
                </directOrIndirectOwnership>
            </ownershipNature>
        </derivativeTransaction>
    </derivativeTable>

    <footnotes>
        <footnote id="F1">Automatic grant to Reporting Person of a non-statutory stock option.  1/48th of the shares vest monthly from the date of grant over four years. The option expires ten years after the date of grant, unless it expires sooner pursuant to the terms of the Company's 2005 Non-Employee Directors' Stock Option Plan.</footnote>
    </footnotes>

    <ownerSignature>
        <signatureName>/s/ Brent D. Fassett, Attorney-in-Fact</signatureName>
        <signatureDate>2009-05-11</signatureDate>
    </ownerSignature>
</ownershipDocument>
