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

    <schemaVersion>X0508</schemaVersion>

    <documentType>4</documentType>

    <periodOfReport>2024-02-27</periodOfReport>

    <issuer>
        <issuerCik>0001027838</issuerCik>
        <issuerName>TACTILE SYSTEMS TECHNOLOGY INC</issuerName>
        <issuerTradingSymbol>TCMD</issuerTradingSymbol>
    </issuer>

    <reportingOwner>
        <reportingOwnerId>
            <rptOwnerCik>0001857721</rptOwnerCik>
            <rptOwnerName>Burns Kristie</rptOwnerName>
        </reportingOwnerId>
        <reportingOwnerAddress>
            <rptOwnerStreet1>3701 WAYZATA BLVD.</rptOwnerStreet1>
            <rptOwnerStreet2>SUITE 300</rptOwnerStreet2>
            <rptOwnerCity>MINNEAPOLIS</rptOwnerCity>
            <rptOwnerState>MN</rptOwnerState>
            <rptOwnerZipCode>55416</rptOwnerZipCode>
            <rptOwnerStateDescription></rptOwnerStateDescription>
        </reportingOwnerAddress>
        <reportingOwnerRelationship>
            <isOfficer>1</isOfficer>
            <officerTitle>Sr. VP Mktg &amp; Clinical Affairs</officerTitle>
        </reportingOwnerRelationship>
    </reportingOwner>

    <aff10b5One>1</aff10b5One>

    <nonDerivativeTable>
        <nonDerivativeTransaction>
            <securityTitle>
                <value>Common Stock</value>
            </securityTitle>
            <transactionDate>
                <value>2024-02-27</value>
            </transactionDate>
            <transactionCoding>
                <transactionFormType>4</transactionFormType>
                <transactionCode>S</transactionCode>
                <equitySwapInvolved>0</equitySwapInvolved>
            </transactionCoding>
            <transactionAmounts>
                <transactionShares>
                    <value>1091</value>
                    <footnoteId id="F1"/>
                    <footnoteId id="F2"/>
                </transactionShares>
                <transactionPricePerShare>
                    <value>15.5831</value>
                    <footnoteId id="F3"/>
                </transactionPricePerShare>
                <transactionAcquiredDisposedCode>
                    <value>D</value>
                </transactionAcquiredDisposedCode>
            </transactionAmounts>
            <postTransactionAmounts>
                <sharesOwnedFollowingTransaction>
                    <value>63632</value>
                    <footnoteId id="F4"/>
                </sharesOwnedFollowingTransaction>
            </postTransactionAmounts>
            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>D</value>
                </directOrIndirectOwnership>
            </ownershipNature>
        </nonDerivativeTransaction>
        <nonDerivativeTransaction>
            <securityTitle>
                <value>Common Stock</value>
            </securityTitle>
            <transactionDate>
                <value>2024-02-29</value>
            </transactionDate>
            <transactionCoding>
                <transactionFormType>4</transactionFormType>
                <transactionCode>S</transactionCode>
                <equitySwapInvolved>0</equitySwapInvolved>
            </transactionCoding>
            <transactionAmounts>
                <transactionShares>
                    <value>243</value>
                    <footnoteId id="F5"/>
                    <footnoteId id="F6"/>
                </transactionShares>
                <transactionPricePerShare>
                    <value>15.2505</value>
                </transactionPricePerShare>
                <transactionAcquiredDisposedCode>
                    <value>D</value>
                </transactionAcquiredDisposedCode>
            </transactionAmounts>
            <postTransactionAmounts>
                <sharesOwnedFollowingTransaction>
                    <value>63389</value>
                </sharesOwnedFollowingTransaction>
            </postTransactionAmounts>
            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>D</value>
                </directOrIndirectOwnership>
            </ownershipNature>
        </nonDerivativeTransaction>
    </nonDerivativeTable>

    <footnotes>
        <footnote id="F1">Consists of shares sold to cover taxes associated with the settlement of stock units, which sales were pursuant to a Rule 10b5-1 instructions on February 24, 2022.</footnote>
        <footnote id="F2">Adoption date of referenced 10b5-1(c) plan is: 02-24-2022.</footnote>
        <footnote id="F3">Reflects the weighted average price of 1,091 shares of common stock of Tactile Systems Technology, Inc. sold by the reporting person in multiple transactions on February 27, 2024 with sale prices ranging from $15.5707 to $15.615 per share. The reporting person undertakes to provide upon request by the U.S. Securities and Exchange Commission staff, the issuer, or a security holder of the issuer, full information regarding the number of shares sold at each separate price.</footnote>
        <footnote id="F4">Includes 1,211 shares acquired under the Company's employee stock purchase plan on November 15, 2023.</footnote>
        <footnote id="F5">Consists of shares sold to cover taxes associated with the settlement of stock units, which sales were pursuant to a Rule 10b5-1 instructions on February 25, 2021.</footnote>
        <footnote id="F6">Adoption date of referenced 10b5-1(c) plan is: 02-24-2022.</footnote>
    </footnotes>

    <ownerSignature>
        <signatureName>/s/ Jonathan Zimmerman, Attorney-in-Fact</signatureName>
        <signatureDate>2024-02-29</signatureDate>
    </ownerSignature>
</ownershipDocument>
