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

    <schemaVersion>X0508</schemaVersion>

    <documentType>4</documentType>

    <periodOfReport>2023-08-31</periodOfReport>

    <issuer>
        <issuerCik>0001444192</issuerCik>
        <issuerName>Acasti Pharma Inc.</issuerName>
        <issuerTradingSymbol>ACST</issuerTradingSymbol>
    </issuer>

    <reportingOwner>
        <reportingOwnerId>
            <rptOwnerCik>0001807762</rptOwnerCik>
            <rptOwnerName>Olds Donald</rptOwnerName>
        </reportingOwnerId>
        <reportingOwnerAddress>
            <rptOwnerStreet1>C/O ACASTI PHARMA INC.</rptOwnerStreet1>
            <rptOwnerStreet2>2572 BOUL. DANIEL-JOHNSON, 2ND FLOOR</rptOwnerStreet2>
            <rptOwnerCity>LAVAL</rptOwnerCity>
            <rptOwnerState>A8</rptOwnerState>
            <rptOwnerZipCode>H7T 2R3</rptOwnerZipCode>
            <rptOwnerStateDescription>QUEBEC, CANADA</rptOwnerStateDescription>
        </reportingOwnerAddress>
        <reportingOwnerRelationship>
            <isDirector>1</isDirector>
            <isOfficer>0</isOfficer>
            <isTenPercentOwner>0</isTenPercentOwner>
            <isOther>0</isOther>
        </reportingOwnerRelationship>
    </reportingOwner>

    <aff10b5One>0</aff10b5One>

    <nonDerivativeTable>
        <nonDerivativeTransaction>
            <securityTitle>
                <value>Common Shares</value>
            </securityTitle>
            <transactionDate>
                <value>2023-08-31</value>
            </transactionDate>
            <transactionCoding>
                <transactionFormType>4</transactionFormType>
                <transactionCode>P</transactionCode>
                <equitySwapInvolved>0</equitySwapInvolved>
            </transactionCoding>
            <transactionAmounts>
                <transactionShares>
                    <value>381</value>
                </transactionShares>
                <transactionPricePerShare>
                    <value>2.05</value>
                </transactionPricePerShare>
                <transactionAcquiredDisposedCode>
                    <value>A</value>
                </transactionAcquiredDisposedCode>
            </transactionAmounts>
            <postTransactionAmounts>
                <sharesOwnedFollowingTransaction>
                    <value>381</value>
                </sharesOwnedFollowingTransaction>
            </postTransactionAmounts>
            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>D</value>
                </directOrIndirectOwnership>
            </ownershipNature>
        </nonDerivativeTransaction>
        <nonDerivativeHolding>
            <securityTitle>
                <value>Common Shares</value>
            </securityTitle>
            <postTransactionAmounts>
                <sharesOwnedFollowingTransaction>
                    <value>792</value>
                    <footnoteId id="F1"/>
                </sharesOwnedFollowingTransaction>
            </postTransactionAmounts>
            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>I</value>
                </directOrIndirectOwnership>
                <natureOfOwnership>
                    <value>Ofra Aslan (Spouse)</value>
                    <footnoteId id="F2"/>
                </natureOfOwnership>
            </ownershipNature>
        </nonDerivativeHolding>
    </nonDerivativeTable>

    <footnotes>
        <footnote id="F1">These indirect holdings have been adjusted to give effect to the Company's 1-for-8 reverse stock split, effective August 31, 2021, and the Company's 1-for-6 reverse stock split, effective July 10, 2023.</footnote>
        <footnote id="F2">792 common shares held by Mr. Olds' wife, Ofra Aslan. Mr. Olds disclaims beneficial ownership of the common shares held by his wife and this report shall not be deemed an admission that Mr. Olds is a beneficial owner of such for purposes of Section 16 of the Securities Exchange Act of 1934, as amended, or for any other purpose.</footnote>
    </footnotes>

    <ownerSignature>
        <signatureName>/s/ Prashant Kohli, as attorney-in-fact</signatureName>
        <signatureDate>2023-09-05</signatureDate>
    </ownerSignature>
</ownershipDocument>
