SCHEDULE 13D/A 0001387131-21-012403 0001863769 XXXXXXXX LIVE 6 Common Stock, $0.001 par value per share 08/18/2025 false 0001348911 483497103 KALVISTA PHARMACEUTICALS, INC.

55 Cambridge Parkway Suite 901E Cambridge MA 02142

Steve R. Bailey (206) 621-7200 601 Union Street, Suite 3200 Seattle WA 98101 0001863769 N Frazier Life Sciences Public Fund, L.P. b WC N DE 0.00 2400276.00 0.00 2400276.00 2400276.00 N 4.8 PN The Percent of Class is calculated based on 49,953,739 shares of the Issuer's Common Stock outstanding as of June 25, 2025, as reported in the Issuer's Annual Report on Form 10-K filed with the SEC on July 10, 2025. 0001879466 N FHMLSP, L.P. b AF N DE 0.00 2400276.00 0.00 2400276.00 2400276.00 N 4.8 PN The Percent of Class is calculated based on 49,953,739 shares of the Issuer's Common Stock outstanding as of June 25, 2025, as reported in the Issuer's Annual Report on Form 10-K filed with the SEC on July 10, 2025. 0001879465 N FHMLSP, L.L.C. b AF N DE 0.00 2400276.00 0.00 2400276.00 2400276.00 N 4.8 OO The Percent of Class is calculated based on 49,953,739 shares of the Issuer's Common Stock outstanding as of June 25, 2025, as reported in the Issuer's Annual Report on Form 10-K filed with the SEC on July 10, 2025. 0001913804 N Frazier Life Sciences Public Overage Fund, L.P. b WC N DE 0.00 946074.00 0.00 946074.00 946074.00 N 1.9 PN The Percent of Class is calculated based on 49,953,739 shares of the Issuer's Common Stock outstanding as of June 25, 2025, as reported in the Issuer's Annual Report on Form 10-K filed with the SEC on July 10, 2025. 0001963247 N FHMLSP Overage, L.P. b AF N DE 0.00 946074.00 0.00 946074.00 946074.00 N 1.9 PN The Percent of Class is calculated based on 49,953,739 shares of the Issuer's Common Stock outstanding as of June 25, 2025, as reported in the Issuer's Annual Report on Form 10-K filed with the SEC on July 10, 2025. 0001963248 N FHMLSP Overage, L.L.C. b AF N DE 0.00 946074.00 0.00 946074.00 946074.00 N 1.9 OO The Percent of Class is calculated based on 49,953,739 shares of the Issuer's Common Stock outstanding as of June 25, 2025, as reported in the Issuer's Annual Report on Form 10-K filed with the SEC on July 10, 2025. 0001790879 N Frazier Life Sciences X, L.P. b WC N DE 0.00 1156869.00 0.00 1156869.00 1156869.00 N 2.3 PN The Percent of Class is calculated based on 49,953,739 shares of the Issuer's Common Stock outstanding as of June 25, 2025, as reported in the Issuer's Annual Report on Form 10-K filed with the SEC on July 10, 2025. 0001790880 N FHMLS X, L.P. b AF N DE 0.00 1156869.00 0.00 1156869.00 1156869.00 N 2.3 PN The Percent of Class is calculated based on 49,953,739 shares of the Issuer's Common Stock outstanding as of June 25, 2025, as reported in the Issuer's Annual Report on Form 10-K filed with the SEC on July 10, 2025. 0001790811 N FHMLS X, L.L.C. b AF N DE 0.00 1156869.00 0.00 1156869.00 1156869.00 N 2.3 OO The Percent of Class is calculated based on 49,953,739 shares of the Issuer's Common Stock outstanding as of June 25, 2025, as reported in the Issuer's Annual Report on Form 10-K filed with the SEC on July 10, 2025. 0001911592 N Frazier Life Sciences XI, L.P. b WC N DE 0.00 384648.00 0.00 384648.00 384648.00 N 0.8 PN The Percent of Class is calculated based on 49,953,739 shares of the Issuer's Common Stock outstanding as of June 25, 2025, as reported in the Issuer's Annual Report on Form 10-K filed with the SEC on July 10, 2025. 0001911580 N FHMLS XI, L.P. b AF N DE 0.00 384648.00 0.00 384648.00 384648.00 N 0.8 PN The Percent of Class is calculated based on 49,953,739 shares of the Issuer's Common Stock outstanding as of June 25, 2025, as reported in the Issuer's Annual Report on Form 10-K filed with the SEC on July 10, 2025. 0001911623 N FHMLS XI, L.L.C. b AF N DE 0.00 384648.00 0.00 384648.00 384648.00 N 0.8 OO The percentage listed in row 13 is calculated based on 49,953,739 shares of the Issuer's Common Stock outstanding as of June 25, 2025, as reported in the Issuer's Annual Report on Form 10-K filed with the SEC on July 10, 2025. 0001341382 N James N. Topper b AF N X1 0.00 1156869.00 0.00 1156869.00 1156869.00 N 2.3 IN The Aggregate Amount represents 1,156,869 shares of Common Stock held directly by Frazier Life Sciences X, L.P. The Percent of Class is calculated based on 49,953,739 shares of the Issuer's Common Stock outstanding as of June 25, 2025, as reported in the Issuer's Annual Report on Form 10-K filed with the SEC on July 10, 2025. 0001365617 N Patrick J. Heron b AF N X1 0.00 1156869.00 0.00 1156869.00 1156869.00 N 2.3 IN The Aggregate Amount represents 1,156,869 shares of Common Stock held directly by Frazier Life Sciences X, L.P. The Percent of Class is calculated based on 49,953,739 shares of the Issuer's Common Stock outstanding as of June 25, 2025, as reported in the Issuer's Annual Report on Form 10-K filed with the SEC on July 10, 2025. 0001397906 N Albert Cha b AF N X1 0.00 0.00 0.00 0.00 0.00 N 0.0 IN 0001865123 N James Brush b AF N X1 0.00 0.00 0.00 0.00 0.00 N 0.0 IN 0001702527 N Daniel Estes b AF N X1 0.00 0.00 0.00 0.00 0.00 N 0.0 IN Common Stock, $0.001 par value per share KALVISTA PHARMACEUTICALS, INC. 55 Cambridge Parkway Suite 901E Cambridge MA 02142 This Amendment No. 6 ("Amendment No. 6") to Schedule 13D amends the statement on Schedule 13D filed on December 30, 2021 (the "Original Schedule 13D") as amended on January 26, 2022, December 30, 2022, December 14, 2023, February 22, 2024 and November 7, 2024 (the "Prior Amendments", and together with the Original Schedule 13D and this Amendment No. 6, the "Schedule 13D"). Except as otherwise specified in Amendment No. 6, all items in the Original Schedule 13D, as amended by the Prior Amendments, are unchanged. All capitalized terms used in this Amendment No. 6 and not otherwise defined herein have the meanings ascribed to such terms in the Original Schedule 13D, as amended by the Prior Amendments. The information contained in Rows 7, 8, 9, 10, 11, and 13 of each Reporting Person's cover page to this Schedule 13D (including the footnotes thereto) is incorporated by reference into this Item 5. FLSPF directly holds 2,400,276 shares of the Issuer's Common Stock (the "FLSPF Shares"). FHMLSP, L.P. is the general partner of FLSPF and the general partner of FHMLSP, L.P. is FHMLSP, L.L.C., which is managed by an investment committee of four that acts by majority vote. Accordingly, no members of such committee are attributed beneficial ownership of the securities directly held by FLSPF, and this Schedule 13D corrects any previous attribution to, and overstatement of beneficial ownership by, such members as reflected in any prior Statements. FLSPOF directly holds 946,074 shares of this Issuer's Common Stock (the "FLSPOF Shares"). FHMLSP Overage, L.P. is the general partner of FLSPOF and the general partner of FHMLSP Overage, L.P. is FHMLSP Overage, L.L.C., which is managed by an investment committee of four that acts by majority vote. Accordingly, no members of such committee are attributed beneficial ownership of the securities directly held by FLSPOF, and this Schedule 13D corrects any previous attribution to, and overstatement of beneficial ownership by, such members as reflected in any prior Statements. FLS X directly holds 1,156,869 shares of the Issuer's Common Stock (the "FLS X Shares"). FHMLS X, L.P. is the general partner of FLS X and FHMLS X, L.L.C. is the general partner of FHMLS X, L.P. Heron and Topper are the members of FHMLS X, L.L.C. and therefore share voting and investment power over the FLS X Shares. FLS XI directly holds 384,648 shares of this Issuer's Common Stock (the "FLS XI Shares"). FHMLS XI, L.P. is the general partner of FLS XI and the general partner of FHMLS XI, L.P. is FHMLS XI, L.L.C., which is managed by an investment committee of three that acts by majority vote. Accordingly, no members of such committee are attributed beneficial ownership of the securities directly held by FLS XI, and this Schedule 13D corrects any previous attribution to, and overstatement of beneficial ownership by, such members as reflected in any prior Statements. Except as specifically stated herein, the filing of this Schedule 13D shall not be construed as an admission that any Reporting Person or any of the foregoing is, for the purposes of Section 13(d) and/or Section 13(g) of the Act or otherwise, the beneficial owner of any securities covered by this Schedule 13D or a member of a "group" with any other person. The information contained in Rows 7, 8, 9, 10, 11, and 13 of each Reporting Person's cover page to this Schedule 13D (including the footnotes thereto) is incorporated by reference into this Item 5. Exhibit 99.1 Joint Filing Agreement (incorporated by reference to Exhibit A to Schedule 13D filed on December 30, 2021) Frazier Life Sciences Public Fund, L.P. /s/ Steve R. Bailey 08/20/2025 FHMLSP, L.P. /s/ Steve R. Bailey 08/20/2025 FHMLSP, L.L.C. /s/ Steve R. Bailey 08/20/2025 Frazier Life Sciences Public Overage Fund, L.P. /s/ Steve R. Bailey 08/20/2025 FHMLSP Overage, L.P. /s/ Steve R. Bailey 08/20/2025 FHMLSP Overage, L.L.C. /s/ Steve R. Bailey 08/20/2025 Frazier Life Sciences X, L.P. /s/ Steve R. Bailey 08/20/2025 FHMLS X, L.P. /s/ Steve R. Bailey 08/20/2025 FHMLS X, L.L.C. /s/ Steve R. Bailey 08/20/2025 Frazier Life Sciences XI, L.P. /s/ Steve R. Bailey 08/20/2025 FHMLS XI, L.P. /s/ Steve R. Bailey 08/20/2025 FHMLS XI, L.L.C. /s/ Steve R. Bailey 08/20/2025 James N. Topper /s/ Steve R. Bailey 08/20/2025 Patrick J. Heron /s/ Steve R. Bailey 08/20/2025 Albert Cha /s/ Steve R. Bailey 08/20/2025 James Brush /s/ Steve R. Bailey 08/20/2025 Daniel Estes /s/ Steve R. Bailey 08/20/2025