<?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>0001857721</cik>
          <ccc>XXXXXXXX</ccc>
        </filerCredentials>
      </filer>
      <liveTestFlag>LIVE</liveTestFlag>



    </filerInfo>
  </headerData>
  <formData>
    <issuerInfo>
      <issuerCik>0001027838</issuerCik>
      <issuerName>TACTILE SYSTEMS TECHNOLOGY INC</issuerName>
      <secFileNumber>001-37799</secFileNumber>
      <issuerAddress>
        <com:street1>1331 TYLER STREET NE STE 200</com:street1>
        <com:city>MINNEAPOLIS</com:city>
        <com:stateOrCountry>MN</com:stateOrCountry>
        <com:zipCode>55413</com:zipCode>
      </issuerAddress>
      <issuerContactPhone>866-435-3948</issuerContactPhone>
      <nameOfPersonForWhoseAccountTheSecuritiesAreToBeSold>Burns Kristie</nameOfPersonForWhoseAccountTheSecuritiesAreToBeSold>
      <relationshipsToIssuer>
        <relationshipToIssuer>Officer</relationshipToIssuer>
      </relationshipsToIssuer>
    </issuerInfo>
    <securitiesInformation>
      <securitiesClassTitle>Common Stock</securitiesClassTitle>
      <brokerOrMarketmakerDetails>
        <name>Merrill Lynch</name>
        <address>
          <com:street1>225 Liberty Street</com:street1>
          <com:street2>Floor 37</com:street2>
          <com:city>New York</com:city>
          <com:stateOrCountry>NY</com:stateOrCountry>
          <com:zipCode>10281</com:zipCode>
        </address>
      </brokerOrMarketmakerDetails>
      <noOfUnitsSold>815</noOfUnitsSold>
      <aggregateMarketValue>11712.74</aggregateMarketValue>
      <noOfUnitsOutstanding>23762164</noOfUnitsOutstanding>
      <approxSaleDate>05/06/2024</approxSaleDate>
      <securitiesExchangeName>NASDAQ</securitiesExchangeName>
    </securitiesInformation>
    <securitiesToBeSold>
      <securitiesClassTitle>Common Stock</securitiesClassTitle>
      <acquiredDate>05/05/2024</acquiredDate>
      <natureOfAcquisitionTransaction>Vesting of restricted stock unit unit award</natureOfAcquisitionTransaction>
      <nameOfPersonfromWhomAcquired>TACTILE SYSTEMS TECHNOLOGY INC</nameOfPersonfromWhomAcquired>
      <isGiftTransaction>N</isGiftTransaction>
      <amountOfSecuritiesAcquired>815</amountOfSecuritiesAcquired>
      <paymentDate>05/05/2024</paymentDate>
      <natureOfPayment>Granted as part of issuer equity compensation plan</natureOfPayment>
    </securitiesToBeSold>
    <nothingToReportFlagOnSecuritiesSoldInPast3Months>N</nothingToReportFlagOnSecuritiesSoldInPast3Months>
    <securitiesSoldInPast3Months>
      <sellerDetails>
        <name>Kristie Burns</name>
        <address>
          <com:street1>1331 TYLER STREET NE STE 200</com:street1>
          <com:city>MINNEAPOLIS</com:city>
          <com:stateOrCountry>MN</com:stateOrCountry>
          <com:zipCode>55413</com:zipCode>
        </address>
      </sellerDetails>
      <securitiesClassTitle>Common Stock</securitiesClassTitle>
      <saleDate>02/23/2024</saleDate>
      <amountOfSecuritiesSold>2249</amountOfSecuritiesSold>
      <grossProceeds>33278.06</grossProceeds>
    </securitiesSoldInPast3Months>
    <securitiesSoldInPast3Months>
      <sellerDetails>
        <name>Kristie Burns</name>
        <address>
          <com:street1>1331 TYLER STREET NE STE 200</com:street1>
          <com:city>MINNEAPOLIS</com:city>
          <com:stateOrCountry>MN</com:stateOrCountry>
          <com:zipCode>55413</com:zipCode>
        </address>
      </sellerDetails>
      <securitiesClassTitle>Common Stock</securitiesClassTitle>
      <saleDate>02/26/2024</saleDate>
      <amountOfSecuritiesSold>2015</amountOfSecuritiesSold>
      <grossProceeds>32048.58</grossProceeds>
    </securitiesSoldInPast3Months>
    <securitiesSoldInPast3Months>
      <sellerDetails>
        <name>Kristie Burns</name>
        <address>
          <com:street1>1331 TYLER STREET NE STE 200</com:street1>
          <com:city>MINNEAPOLIS</com:city>
          <com:stateOrCountry>MN</com:stateOrCountry>
          <com:zipCode>55413</com:zipCode>
        </address>
      </sellerDetails>
      <securitiesClassTitle>Common Stock</securitiesClassTitle>
      <saleDate>02/27/2024</saleDate>
      <amountOfSecuritiesSold>1091</amountOfSecuritiesSold>
      <grossProceeds>17001.15</grossProceeds>
    </securitiesSoldInPast3Months>
    <securitiesSoldInPast3Months>
      <sellerDetails>
        <name>Kristie Burns</name>
        <address>
          <com:street1>1331 TYLER STREET NE STE 200</com:street1>
          <com:city>MINNEAPOLIS</com:city>
          <com:stateOrCountry>MN</com:stateOrCountry>
          <com:zipCode>55413</com:zipCode>
        </address>
      </sellerDetails>
      <securitiesClassTitle>Common Stock</securitiesClassTitle>
      <saleDate>02/29/2024</saleDate>
      <amountOfSecuritiesSold>243</amountOfSecuritiesSold>
      <grossProceeds>3705.87</grossProceeds>
    </securitiesSoldInPast3Months>
    <securitiesSoldInPast3Months>
      <sellerDetails>
        <name>Kristie Burns</name>
        <address>
          <com:street1>1331 TYLER STREET NE STE 200</com:street1>
          <com:city>MINNEAPOLIS</com:city>
          <com:stateOrCountry>MN</com:stateOrCountry>
          <com:zipCode>55413</com:zipCode>
        </address>
      </sellerDetails>
      <securitiesClassTitle>Common Stock</securitiesClassTitle>
      <saleDate>03/12/2024</saleDate>
      <amountOfSecuritiesSold>236</amountOfSecuritiesSold>
      <grossProceeds>3745.32</grossProceeds>
    </securitiesSoldInPast3Months>
    <noticeSignature>
      <noticeDate>05/06/2024</noticeDate>
      <signature>Kristie Burns</signature>
    </noticeSignature>
  </formData>
</edgarSubmission>
