<?xml version="1.0"?>
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    <schemaVersion>X0708</schemaVersion>

    <submissionType>D</submissionType>

    <testOrLive>LIVE</testOrLive>

    <primaryIssuer>
        <cik>0001478192</cik>
        <entityName>Gateway Ambulatory Surgery Center, LLC</entityName>
        <issuerAddress>
            <street1>1025 NORTHEAST GATEWAY COURT, NE</street1>
            <city>CONCORD</city>
            <stateOrCountry>NC</stateOrCountry>
            <stateOrCountryDescription>NORTH CAROLINA</stateOrCountryDescription>
            <zipCode>28025</zipCode>
        </issuerAddress>
        <issuerPhoneNumber>704-920-7027</issuerPhoneNumber>
        <jurisdictionOfInc>NORTH CAROLINA</jurisdictionOfInc>
        <issuerPreviousNameList>
            <value>None</value>
        </issuerPreviousNameList>
        <edgarPreviousNameList>
            <value>None</value>
        </edgarPreviousNameList>
        <entityType>Limited Liability Company</entityType>
        <yearOfInc>
            <overFiveYears>true</overFiveYears>
        </yearOfInc>
    </primaryIssuer>

    <relatedPersonsList>
        <relatedPersonInfo>
            <relatedPersonName>
                <firstName>Asha</firstName>
                <lastName>Rodriquez</lastName>
            </relatedPersonName>
            <relatedPersonAddress>
                <street1>920 Church Street N</street1>
                <city>Concord</city>
                <stateOrCountry>NC</stateOrCountry>
                <stateOrCountryDescription>NORTH CAROLINA</stateOrCountryDescription>
                <zipCode>28025</zipCode>
            </relatedPersonAddress>
            <relatedPersonRelationshipList>
                <relationship>Director</relationship>
            </relatedPersonRelationshipList>
            <relationshipClarification></relationshipClarification>
        </relatedPersonInfo>
        <relatedPersonInfo>
            <relatedPersonName>
                <firstName>Francis</firstName>
                <lastName>Langford</lastName>
            </relatedPersonName>
            <relatedPersonAddress>
                <street1>645 Amalia Street</street1>
                <city>Concord</city>
                <stateOrCountry>NC</stateOrCountry>
                <stateOrCountryDescription>NORTH CAROLINA</stateOrCountryDescription>
                <zipCode>28025</zipCode>
            </relatedPersonAddress>
            <relatedPersonRelationshipList>
                <relationship>Executive Officer</relationship>
                <relationship>Director</relationship>
            </relatedPersonRelationshipList>
            <relationshipClarification></relationshipClarification>
        </relatedPersonInfo>
        <relatedPersonInfo>
            <relatedPersonName>
                <firstName>Scott</firstName>
                <lastName>Moroney</lastName>
            </relatedPersonName>
            <relatedPersonAddress>
                <street1>920 Church Street N</street1>
                <city>Concord</city>
                <stateOrCountry>NC</stateOrCountry>
                <stateOrCountryDescription>NORTH CAROLINA</stateOrCountryDescription>
                <zipCode>28025</zipCode>
            </relatedPersonAddress>
            <relatedPersonRelationshipList>
                <relationship>Director</relationship>
            </relatedPersonRelationshipList>
            <relationshipClarification></relationshipClarification>
        </relatedPersonInfo>
        <relatedPersonInfo>
            <relatedPersonName>
                <firstName>Robert</firstName>
                <lastName>Bashore</lastName>
            </relatedPersonName>
            <relatedPersonAddress>
                <street1>1025 Northeast Gateway Court, NE</street1>
                <city>Concord</city>
                <stateOrCountry>NC</stateOrCountry>
                <stateOrCountryDescription>NORTH CAROLINA</stateOrCountryDescription>
                <zipCode>28025</zipCode>
            </relatedPersonAddress>
            <relatedPersonRelationshipList>
                <relationship>Executive Officer</relationship>
            </relatedPersonRelationshipList>
            <relationshipClarification></relationshipClarification>
        </relatedPersonInfo>
        <relatedPersonInfo>
            <relatedPersonName>
                <firstName>Brian</firstName>
                <lastName>Schmidt</lastName>
            </relatedPersonName>
            <relatedPersonAddress>
                <street1>200 Medical Park Drive</street1>
                <street2>Suite 400</street2>
                <city>Concord</city>
                <stateOrCountry>NC</stateOrCountry>
                <stateOrCountryDescription>NORTH CAROLINA</stateOrCountryDescription>
                <zipCode>28025</zipCode>
            </relatedPersonAddress>
            <relatedPersonRelationshipList>
                <relationship>Director</relationship>
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        </relatedPersonInfo>
        <relatedPersonInfo>
            <relatedPersonName>
                <firstName>Rami</firstName>
                <lastName>Zebian</lastName>
            </relatedPersonName>
            <relatedPersonAddress>
                <street1>920 Church Street N</street1>
                <city>Concord</city>
                <stateOrCountry>NC</stateOrCountry>
                <stateOrCountryDescription>NORTH CAROLINA</stateOrCountryDescription>
                <zipCode>28025</zipCode>
            </relatedPersonAddress>
            <relatedPersonRelationshipList>
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            <relationshipClarification></relationshipClarification>
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        <relatedPersonInfo>
            <relatedPersonName>
                <firstName>William</firstName>
                <lastName>Goglin</lastName>
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            <relatedPersonAddress>
                <street1>1025 Northeast Gateway Court, NE</street1>
                <city>Concord</city>
                <stateOrCountry>NC</stateOrCountry>
                <stateOrCountryDescription>NORTH CAROLINA</stateOrCountryDescription>
                <zipCode>28025</zipCode>
            </relatedPersonAddress>
            <relatedPersonRelationshipList>
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            <relationshipClarification></relationshipClarification>
        </relatedPersonInfo>
        <relatedPersonInfo>
            <relatedPersonName>
                <firstName>Andrew</firstName>
                <lastName>Ferris</lastName>
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            <relatedPersonAddress>
                <street1>1090 Northeast Gateway Court, NE</street1>
                <city>Concord</city>
                <stateOrCountry>NC</stateOrCountry>
                <stateOrCountryDescription>NORTH CAROLINA</stateOrCountryDescription>
                <zipCode>28025</zipCode>
            </relatedPersonAddress>
            <relatedPersonRelationshipList>
                <relationship>Director</relationship>
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            <relationshipClarification></relationshipClarification>
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        <relatedPersonInfo>
            <relatedPersonName>
                <firstName>Matthew</firstName>
                <lastName>Myers</lastName>
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            <relatedPersonAddress>
                <street1>1070 Vinehaven Drive</street1>
                <city>Concord</city>
                <stateOrCountry>NC</stateOrCountry>
                <stateOrCountryDescription>NORTH CAROLINA</stateOrCountryDescription>
                <zipCode>28025</zipCode>
            </relatedPersonAddress>
            <relatedPersonRelationshipList>
                <relationship>Director</relationship>
            </relatedPersonRelationshipList>
            <relationshipClarification></relationshipClarification>
        </relatedPersonInfo>
        <relatedPersonInfo>
            <relatedPersonName>
                <firstName>Joseph</firstName>
                <lastName>Simpson</lastName>
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            <relatedPersonAddress>
                <street1>920 Church Street N</street1>
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                <stateOrCountry>NC</stateOrCountry>
                <stateOrCountryDescription>NORTH CAROLINA</stateOrCountryDescription>
                <zipCode>28025</zipCode>
            </relatedPersonAddress>
            <relatedPersonRelationshipList>
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            <relationshipClarification></relationshipClarification>
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    </relatedPersonsList>

    <offeringData>
        <industryGroup>
            <industryGroupType>Hospitals and Physicians</industryGroupType>
        </industryGroup>
        <issuerSize>
            <revenueRange>Decline to Disclose</revenueRange>
        </issuerSize>
        <federalExemptionsExclusions>
            <item>06b</item>
            <item>4a5</item>
        </federalExemptionsExclusions>
        <typeOfFiling>
            <newOrAmendment>
                <isAmendment>false</isAmendment>
            </newOrAmendment>
            <dateOfFirstSale>
                <yetToOccur>true</yetToOccur>
            </dateOfFirstSale>
        </typeOfFiling>
        <durationOfOffering>
            <moreThanOneYear>false</moreThanOneYear>
        </durationOfOffering>
        <typesOfSecuritiesOffered>
            <isEquityType>true</isEquityType>
        </typesOfSecuritiesOffered>
        <businessCombinationTransaction>
            <isBusinessCombinationTransaction>false</isBusinessCombinationTransaction>
            <clarificationOfResponse></clarificationOfResponse>
        </businessCombinationTransaction>
        <minimumInvestmentAccepted>18675</minimumInvestmentAccepted>
        <salesCompensationList></salesCompensationList>
        <offeringSalesAmounts>
            <totalOfferingAmount>507586</totalOfferingAmount>
            <totalAmountSold>0</totalAmountSold>
            <totalRemaining>507586</totalRemaining>
            <clarificationOfResponse></clarificationOfResponse>
        </offeringSalesAmounts>
        <investors>
            <hasNonAccreditedInvestors>false</hasNonAccreditedInvestors>
            <totalNumberAlreadyInvested>0</totalNumberAlreadyInvested>
        </investors>
        <salesCommissionsFindersFees>
            <salesCommissions>
                <dollarAmount>0</dollarAmount>
            </salesCommissions>
            <findersFees>
                <dollarAmount>0</dollarAmount>
            </findersFees>
            <clarificationOfResponse></clarificationOfResponse>
        </salesCommissionsFindersFees>
        <useOfProceeds>
            <grossProceedsUsed>
                <dollarAmount>0</dollarAmount>
                <isEstimate>true</isEstimate>
            </grossProceedsUsed>
            <clarificationOfResponse>Offering proceeds may be used to make distributions among the members in proportion to their ownership, and the members include persons that are also executive officers and/or directors.</clarificationOfResponse>
        </useOfProceeds>
        <signatureBlock>
            <authorizedRepresentative>false</authorizedRepresentative>
            <signature>
                <issuerName>Gateway Ambulatory Surgery Center, LLC</issuerName>
                <signatureName>/s/ F.P. Johns Langford, M.D.</signatureName>
                <nameOfSigner>F.P. Johns Langford, M.D.</nameOfSigner>
                <signatureTitle>President</signatureTitle>
                <signatureDate>2026-06-23</signatureDate>
            </signature>
        </signatureBlock>
    </offeringData>
</edgarSubmission>
