<?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>0000918697</cik>
          <ccc>XXXXXXXX</ccc>
        </filerCredentials>
      </filer>
      <liveTestFlag>LIVE</liveTestFlag>



    </filerInfo>
  </headerData>
  <formData>
    <issuerInfo>
      <issuerCik>0001320414</issuerCik>
      <issuerName>SELECT MEDICAL HOLDINGS CORP</issuerName>
      <secFileNumber>001-34465</secFileNumber>
      <issuerAddress>
        <com:street1>C/O SELECT MEDICAL CORP</com:street1>
        <com:street2>4714 GETTYSBURG RD</com:street2>
        <com:city>MECHANICSBURG</com:city>
        <com:stateOrCountry>PA</com:stateOrCountry>
        <com:zipCode>17055</com:zipCode>
      </issuerAddress>
      <issuerContactPhone>717-972-1100</issuerContactPhone>
      <nameOfPersonForWhoseAccountTheSecuritiesAreToBeSold>ORTENZIO ROBERT A</nameOfPersonForWhoseAccountTheSecuritiesAreToBeSold>
      <relationshipsToIssuer>
        <relationshipToIssuer>Officer</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>1295000.00</aggregateMarketValue>
      <noOfUnitsOutstanding>128213538</noOfUnitsOutstanding>
      <approxSaleDate>02/08/2024</approxSaleDate>
      <securitiesExchangeName>NYSE</securitiesExchangeName>
    </securitiesInformation>
    <securitiesToBeSold>
      <securitiesClassTitle>Common</securitiesClassTitle>
      <acquiredDate>12/28/2016</acquiredDate>
      <natureOfAcquisitionTransaction>Company Grant</natureOfAcquisitionTransaction>
      <nameOfPersonfromWhomAcquired>Issuer</nameOfPersonfromWhomAcquired>
      <isGiftTransaction>N</isGiftTransaction>
      <amountOfSecuritiesAcquired>2708</amountOfSecuritiesAcquired>
      <paymentDate>12/28/2016</paymentDate>
      <natureOfPayment>CASH</natureOfPayment>
    </securitiesToBeSold>
    <securitiesToBeSold>
      <securitiesClassTitle>Common</securitiesClassTitle>
      <acquiredDate>10/30/2015</acquiredDate>
      <natureOfAcquisitionTransaction>Company Grant</natureOfAcquisitionTransaction>
      <nameOfPersonfromWhomAcquired>Issuer</nameOfPersonfromWhomAcquired>
      <isGiftTransaction>N</isGiftTransaction>
      <amountOfSecuritiesAcquired>16666</amountOfSecuritiesAcquired>
      <paymentDate>10/30/2015</paymentDate>
      <natureOfPayment>CASH</natureOfPayment>
    </securitiesToBeSold>
    <securitiesToBeSold>
      <securitiesClassTitle>Common</securitiesClassTitle>
      <acquiredDate>12/15/2014</acquiredDate>
      <natureOfAcquisitionTransaction>Company Grant</natureOfAcquisitionTransaction>
      <nameOfPersonfromWhomAcquired>Issuer</nameOfPersonfromWhomAcquired>
      <isGiftTransaction>N</isGiftTransaction>
      <amountOfSecuritiesAcquired>16667</amountOfSecuritiesAcquired>
      <paymentDate>12/15/2014</paymentDate>
      <natureOfPayment>CASH</natureOfPayment>
    </securitiesToBeSold>
    <securitiesToBeSold>
      <securitiesClassTitle>Common</securitiesClassTitle>
      <acquiredDate>09/25/2009</acquiredDate>
      <natureOfAcquisitionTransaction>Company Grant</natureOfAcquisitionTransaction>
      <nameOfPersonfromWhomAcquired>Issuer</nameOfPersonfromWhomAcquired>
      <isGiftTransaction>N</isGiftTransaction>
      <amountOfSecuritiesAcquired>13959</amountOfSecuritiesAcquired>
      <paymentDate>09/25/2009</paymentDate>
      <natureOfPayment>CASH</natureOfPayment>
    </securitiesToBeSold>
    <nothingToReportFlagOnSecuritiesSoldInPast3Months>N</nothingToReportFlagOnSecuritiesSoldInPast3Months>
    <securitiesSoldInPast3Months>
      <sellerDetails>
        <name>Robert Ortenzio</name>
        <address>
          <com:street1>C/O Select Medical Corp</com:street1>
          <com:street2>4714 Gettysburg Road</com:street2>
          <com:city>Mechanicsburg</com:city>
          <com:stateOrCountry>PA</com:stateOrCountry>
          <com:zipCode>17055</com:zipCode>
        </address>
      </sellerDetails>
      <securitiesClassTitle>Common</securitiesClassTitle>
      <saleDate>12/14/2023</saleDate>
      <amountOfSecuritiesSold>100000</amountOfSecuritiesSold>
      <grossProceeds>2500000.00</grossProceeds>
    </securitiesSoldInPast3Months>
    <securitiesSoldInPast3Months>
      <sellerDetails>
        <name>Robert Ortenzio</name>
        <address>
          <com:street1>C/O Select Medical Corp</com:street1>
          <com:street2>4714 Gettysburg Road</com:street2>
          <com:city>Mechanicsburg</com:city>
          <com:stateOrCountry>PA</com:stateOrCountry>
          <com:zipCode>17055</com:zipCode>
        </address>
      </sellerDetails>
      <securitiesClassTitle>Common</securitiesClassTitle>
      <saleDate>01/08/2024</saleDate>
      <amountOfSecuritiesSold>100000</amountOfSecuritiesSold>
      <grossProceeds>2662800.00</grossProceeds>
    </securitiesSoldInPast3Months>
    <noticeSignature>
      <noticeDate>02/08/2024</noticeDate>
      <planAdoptionDates>
        <planAdoptionDate>12/09/2022</planAdoptionDate>
      </planAdoptionDates>
      <signature>/s/ UBS Financial Services Inc, as attorney-in-fact for Robert Ortenzio</signature>
    </noticeSignature>
  </formData>
</edgarSubmission>
