<?xml version="1.0" encoding="UTF-8"?><edgarSubmission xmlns="http://www.sec.gov/edgar/ownership" xmlns:ns2="http://www.sec.gov/edgar/common">
    <headerData>
        <submissionType>144</submissionType>
        <filerInfo>
            <filer>
                <filerCredentials>
                    <cik>0001782815</cik>
                    <ccc>XXXXXXXX</ccc>
                </filerCredentials>
            </filer>
            <liveTestFlag>LIVE</liveTestFlag>



        </filerInfo>
    </headerData>
    <formData>
        <issuerInfo>
            <issuerCik>0001447362</issuerCik>
            <issuerName>CASTLE BIOSCIENCES INC</issuerName>
            <secFileNumber>001-38984</secFileNumber>
            <issuerAddress>
                <ns2:street1>505 S. Friendswood Drive, Suite 401</ns2:street1>
                <ns2:city>Friendstown</ns2:city>
                <ns2:stateOrCountry>TX</ns2:stateOrCountry>
                <ns2:zipCode>77546</ns2:zipCode>
            </issuerAddress>
            <issuerContactPhone>8667889007</issuerContactPhone>
            <nameOfPersonForWhoseAccountTheSecuritiesAreToBeSold>FRANKLIN STOKES</nameOfPersonForWhoseAccountTheSecuritiesAreToBeSold>
            <relationshipsToIssuer>
                <relationshipToIssuer>Officer</relationshipToIssuer>
            </relationshipsToIssuer>
        </issuerInfo>
        <securitiesInformation>
            <securitiesClassTitle>Common</securitiesClassTitle>
            <brokerOrMarketmakerDetails>
                <name>Morgan Stanley Smith Barney LLC Executive Financial Services</name>
                <address>
                    <ns2:street1>1 New York Plaza</ns2:street1>
                    <ns2:street2>8th Floor</ns2:street2>
                    <ns2:city>New York</ns2:city>
                    <ns2:stateOrCountry>NY</ns2:stateOrCountry>
                    <ns2:zipCode>10004</ns2:zipCode>
                </address>
            </brokerOrMarketmakerDetails>
            <noOfUnitsSold>5388</noOfUnitsSold>
            <aggregateMarketValue>187179.12</aggregateMarketValue>
            <noOfUnitsOutstanding>29188659</noOfUnitsOutstanding>
            <approxSaleDate>11/11/2025</approxSaleDate>
            <securitiesExchangeName>NASDAQ</securitiesExchangeName>
        </securitiesInformation>
        <securitiesToBeSold>
            <securitiesClassTitle>Common</securitiesClassTitle>
            <acquiredDate>08/08/2025</acquiredDate>
            <natureOfAcquisitionTransaction>Performance Stock Units</natureOfAcquisitionTransaction>
            <nameOfPersonfromWhomAcquired>Issuer</nameOfPersonfromWhomAcquired>
            <isGiftTransaction>N</isGiftTransaction>
            <amountOfSecuritiesAcquired>5388</amountOfSecuritiesAcquired>
            <paymentDate>08/08/2025</paymentDate>
            <natureOfPayment>N/A</natureOfPayment>
        </securitiesToBeSold>
        <nothingToReportFlagOnSecuritiesSoldInPast3Months>Y</nothingToReportFlagOnSecuritiesSoldInPast3Months>
        <remarks>Sales that were executed on November 11, 2025 are being reported on this Form 144 filed on November 12, 2025 given the EDGAR system was not accepting filings on November 11, 2025 in observance of the federal holiday.</remarks>
        <noticeSignature>
            <noticeDate>11/11/2025</noticeDate>
            <planAdoptionDates>
                <planAdoptionDate>08/12/2025</planAdoptionDate>
            </planAdoptionDates>
            <signature>/s/ Franklin Stokes</signature>
        </noticeSignature>
    </formData>
</edgarSubmission>
