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                          April 17, 2023

       Alexandra MacLean, M.D.
       Chief Executive Officer
       Avenue Therapeutics, Inc.
       1111 Kane Concourse, Suite 301
       Bay Harbor Islands, Florida 33154

                                                        Re: Avenue
Therapeutics, Inc.
                                                            Registration
Statement on Form S-1
                                                            Filed April 11,
2023
                                                            File No. 333-271208

       Dear Alexandra MacLean:

              This is to advise you that we have not reviewed and will not
review your registration
       statement.

               Please refer to Rules 460 and 461 regarding requests for
acceleration. We remind you
       that the company and its management are responsible for the accuracy and
adequacy of their
       disclosures, notwithstanding any review, comments, action or absence of
action by the staff.

                                                        Please contact Alan
Campbell at 202-551-4224 with any questions.




                          Sincerely,


                          Division of Corporation Finance

                          Office of Life Sciences
       cc:                                              David S. Wolpa