<?xml version="1.0" encoding="UTF-8"?><edgarSubmission xmlns="http://www.sec.gov/edgar/ownership" xmlns:com="http://www.sec.gov/edgar/common">
  <headerData>
    <submissionType>144</submissionType>
    <filerInfo>
      <filer>
        <filerCredentials>
          <cik>0001524599</cik>
          <ccc>XXXXXXXX</ccc>
        </filerCredentials>
      </filer>
      <liveTestFlag>LIVE</liveTestFlag>



    </filerInfo>
  </headerData>
  <formData>
    <issuerInfo>
      <issuerCik>0001668397</issuerCik>
      <issuerName>Medpace Holding, Inc.</issuerName>
      <secFileNumber>001-37856</secFileNumber>
      <issuerAddress>
        <com:street1>5375 Medpace Way</com:street1>
        <com:city>Cincinnati</com:city>
        <com:stateOrCountry>OH</com:stateOrCountry>
        <com:zipCode>45227</com:zipCode>
      </issuerAddress>
      <issuerContactPhone>513-579-9911</issuerContactPhone>
      <nameOfPersonForWhoseAccountTheSecuritiesAreToBeSold>Medpace Investors, LLC</nameOfPersonForWhoseAccountTheSecuritiesAreToBeSold>
      <relationshipsToIssuer>
        <relationshipToIssuer>Affiliate</relationshipToIssuer>
      </relationshipsToIssuer>
    </issuerInfo>
    <securitiesInformation>
      <securitiesClassTitle>Common</securitiesClassTitle>
      <brokerOrMarketmakerDetails>
        <name>UBS Financial Services Inc</name>
        <address>
          <com:street1>1000 Harbor Blvd</com:street1>
          <com:street2>3rd Floor</com:street2>
          <com:city>Weehawken</com:city>
          <com:stateOrCountry>NJ</com:stateOrCountry>
          <com:zipCode>07086</com:zipCode>
        </address>
      </brokerOrMarketmakerDetails>
      <noOfUnitsSold>50000</noOfUnitsSold>
      <aggregateMarketValue>19587000</aggregateMarketValue>
      <noOfUnitsOutstanding>30759281</noOfUnitsOutstanding>
      <approxSaleDate>02/16/2024</approxSaleDate>
      <securitiesExchangeName>NASDAQ</securitiesExchangeName>
    </securitiesInformation>
    <securitiesToBeSold>
      <securitiesClassTitle>Common</securitiesClassTitle>
      <acquiredDate>09/15/2022</acquiredDate>
      <natureOfAcquisitionTransaction>Open Market Purchase</natureOfAcquisitionTransaction>
      <nameOfPersonfromWhomAcquired>Issuer</nameOfPersonfromWhomAcquired>
      <isGiftTransaction>N</isGiftTransaction>
      <amountOfSecuritiesAcquired>4629</amountOfSecuritiesAcquired>
      <paymentDate>09/15/2022</paymentDate>
      <natureOfPayment>Cash</natureOfPayment>
    </securitiesToBeSold>
    <securitiesToBeSold>
      <securitiesClassTitle>Common</securitiesClassTitle>
      <acquiredDate>09/16/2022</acquiredDate>
      <natureOfAcquisitionTransaction>Open market purchase</natureOfAcquisitionTransaction>
      <nameOfPersonfromWhomAcquired>Issuer</nameOfPersonfromWhomAcquired>
      <isGiftTransaction>N</isGiftTransaction>
      <amountOfSecuritiesAcquired>45371</amountOfSecuritiesAcquired>
      <paymentDate>09/16/2022</paymentDate>
      <natureOfPayment>Cash</natureOfPayment>
    </securitiesToBeSold>
    <nothingToReportFlagOnSecuritiesSoldInPast3Months>N</nothingToReportFlagOnSecuritiesSoldInPast3Months>
    <securitiesSoldInPast3Months>
      <sellerDetails>
        <name>Medpace Investors, LLC</name>
        <address>
          <com:street1>5375 Medpace Way</com:street1>
          <com:city>Cincinnati</com:city>
          <com:stateOrCountry>OH</com:stateOrCountry>
          <com:zipCode>45227</com:zipCode>
        </address>
      </sellerDetails>
      <securitiesClassTitle>Common</securitiesClassTitle>
      <saleDate>11/16/2023</saleDate>
      <amountOfSecuritiesSold>17000</amountOfSecuritiesSold>
      <grossProceeds>4787307</grossProceeds>
    </securitiesSoldInPast3Months>
    <securitiesSoldInPast3Months>
      <sellerDetails>
        <name>Medpace Investors LLC</name>
        <address>
          <com:street1>5375 Medpace Way</com:street1>
          <com:city>Cincinnati</com:city>
          <com:stateOrCountry>OH</com:stateOrCountry>
          <com:zipCode>45227</com:zipCode>
        </address>
      </sellerDetails>
      <securitiesClassTitle>Common</securitiesClassTitle>
      <saleDate>11/17/2023</saleDate>
      <amountOfSecuritiesSold>50000</amountOfSecuritiesSold>
      <grossProceeds>13695380</grossProceeds>
    </securitiesSoldInPast3Months>
    <securitiesSoldInPast3Months>
      <sellerDetails>
        <name>Medpace Investors LLC</name>
        <address>
          <com:street1>5375 Medpace Way</com:street1>
          <com:city>Cincinnati</com:city>
          <com:stateOrCountry>OH</com:stateOrCountry>
          <com:zipCode>45227</com:zipCode>
        </address>
      </sellerDetails>
      <securitiesClassTitle>Common</securitiesClassTitle>
      <saleDate>11/20/2023</saleDate>
      <amountOfSecuritiesSold>50000</amountOfSecuritiesSold>
      <grossProceeds>13772500</grossProceeds>
    </securitiesSoldInPast3Months>
    <securitiesSoldInPast3Months>
      <sellerDetails>
        <name>Medpace Investors LLC</name>
        <address>
          <com:street1>5375 Medpace Way</com:street1>
          <com:city>Cincinnati</com:city>
          <com:stateOrCountry>OH</com:stateOrCountry>
          <com:zipCode>45227</com:zipCode>
        </address>
      </sellerDetails>
      <securitiesClassTitle>Common</securitiesClassTitle>
      <saleDate>11/21/2023</saleDate>
      <amountOfSecuritiesSold>25000</amountOfSecuritiesSold>
      <grossProceeds>6934750</grossProceeds>
    </securitiesSoldInPast3Months>
    <securitiesSoldInPast3Months>
      <sellerDetails>
        <name>Medpace Investors LLC</name>
        <address>
          <com:street1>5375 Medpace Way</com:street1>
          <com:city>Cincinnati</com:city>
          <com:stateOrCountry>OH</com:stateOrCountry>
          <com:zipCode>45227</com:zipCode>
        </address>
      </sellerDetails>
      <securitiesClassTitle>Common</securitiesClassTitle>
      <saleDate>11/22/2023</saleDate>
      <amountOfSecuritiesSold>25000</amountOfSecuritiesSold>
      <grossProceeds>6945000</grossProceeds>
    </securitiesSoldInPast3Months>
    <securitiesSoldInPast3Months>
      <sellerDetails>
        <name>Medpace Investors LLC</name>
        <address>
          <com:street1>5375 Medpace Way</com:street1>
          <com:city>Cincinnati</com:city>
          <com:stateOrCountry>OH</com:stateOrCountry>
          <com:zipCode>45227</com:zipCode>
        </address>
      </sellerDetails>
      <securitiesClassTitle>Common</securitiesClassTitle>
      <saleDate>11/27/2023</saleDate>
      <amountOfSecuritiesSold>25000</amountOfSecuritiesSold>
      <grossProceeds>6902500</grossProceeds>
    </securitiesSoldInPast3Months>
    <securitiesSoldInPast3Months>
      <sellerDetails>
        <name>Medpace Investors LLC</name>
        <address>
          <com:street1>5374 Medpace Way</com:street1>
          <com:city>Cincinnati</com:city>
          <com:stateOrCountry>OH</com:stateOrCountry>
          <com:zipCode>45227</com:zipCode>
        </address>
      </sellerDetails>
      <securitiesClassTitle>Common</securitiesClassTitle>
      <saleDate>11/28/2023</saleDate>
      <amountOfSecuritiesSold>21833</amountOfSecuritiesSold>
      <grossProceeds>5974600</grossProceeds>
    </securitiesSoldInPast3Months>
    <securitiesSoldInPast3Months>
      <sellerDetails>
        <name>Medpace Investors LLC</name>
        <address>
          <com:street1>5375 Medpace Way</com:street1>
          <com:city>Cincinnati</com:city>
          <com:stateOrCountry>OH</com:stateOrCountry>
          <com:zipCode>45227</com:zipCode>
        </address>
      </sellerDetails>
      <securitiesClassTitle>Common</securitiesClassTitle>
      <saleDate>11/29/2023</saleDate>
      <amountOfSecuritiesSold>21257</amountOfSecuritiesSold>
      <grossProceeds>4934409</grossProceeds>
    </securitiesSoldInPast3Months>
    <securitiesSoldInPast3Months>
      <sellerDetails>
        <name>Medpace Investors LLC</name>
        <address>
          <com:street1>5375 Medpace Way</com:street1>
          <com:city>Cincinnati</com:city>
          <com:stateOrCountry>OH</com:stateOrCountry>
          <com:zipCode>45227</com:zipCode>
        </address>
      </sellerDetails>
      <securitiesClassTitle>Common</securitiesClassTitle>
      <saleDate>11/30/2023</saleDate>
      <amountOfSecuritiesSold>7871</amountOfSecuritiesSold>
      <grossProceeds>2142329</grossProceeds>
    </securitiesSoldInPast3Months>
    <securitiesSoldInPast3Months>
      <sellerDetails>
        <name>Medpace Investors LLC</name>
        <address>
          <com:street1>5375 Medpace Way</com:street1>
          <com:city>Cincinnati</com:city>
          <com:stateOrCountry>OH</com:stateOrCountry>
          <com:zipCode>45227</com:zipCode>
        </address>
      </sellerDetails>
      <securitiesClassTitle>Common</securitiesClassTitle>
      <saleDate>12/01/2023</saleDate>
      <amountOfSecuritiesSold>24039</amountOfSecuritiesSold>
      <grossProceeds>6568657</grossProceeds>
    </securitiesSoldInPast3Months>
    <noticeSignature>
      <noticeDate>02/16/2024</noticeDate>
      <signature>/s/ UBS Financial Services Inc, as attorney-in-fact for Medpace Investors, LLC</signature>
    </noticeSignature>
  </formData>
</edgarSubmission>
