X0306 4 2020-06-05 0 0001408443 Milestone Pharmaceuticals Inc. MIST 0001120362 TRUEX PAUL F C/O MILESTONE PHARMACEUTICALS INC. 1111 DR. FREDERIK-PHILIPS BLVD, STE 420 MONTR?AL A8 H4M 2X6 QUEBEC, CANADA 1 0 0 0 Stock Option (right to buy) 3.74 2020-06-05 4 A 0 15000 0.00 A 2030-06-05 Common Shares 15000 15000 D The shares subject to this option shall vest in equal monthly installments over the 12 months commencing July 5, 2020, provided that the shares subject to this option shall vest in full on the date of Issuer's 2021 annual meeting of shareholders, subject to recipient continuing to provide service to the Issuer through such vesting date. /s/ Eric Popp, Attorney-in-Fact 2020-06-08