Madrigal Pharmaceuticals Investor Presentation — November 2021

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Resmetirom AASLD Clinical Data Review

Tuesday, November 16th, 2021

2Any statements, other than statements of historical facts, made in this presentation are, or may be deemed, forward -looking stat ements within the meaning of the

Private Securities Litigation Reform Act of 1995. Examples of these forward -looking statements include those concerning: our pri mary and secondary study endpoints and

supportive data for resmetirom, and the potential for achieving such endpoints, projections and accelerated approval objectiv es;first to market or NASH market

leadership statements; projections regarding potential future NASH resolution, safety, efficacy, fibrosis treatment, cardiova scular effects, lipid treatment or biomarker

effects with resmetirom; competitive positioning; NDA filing estimates; the estimated size and diagnosis and treatment rates forour target patient market; projected

clinical utility for resmetirom; U.S. launch and market positioning projections; ex -U.S. launch/partnering plans; the ability t o develop clinical evidence demonstrating the

utility of non -invasive tools and techniques to screen and diagnose NASH and/or NAFLD patients; the predictive power of liver vo lume, MAST and/or non -invasive tests

generally; study liver biopsy trends regarding fibrosis and NASH resolution; our Phase 3 trials’ powering objectives; our stu dy and development timelines; our future

financial or business performance, conditions, plans, prospects, trends, or strategies and other financial and business matte rs;our ability to obtain additional financing;

the estimated size of the market for our product candidates; the timing and success of our development and commercialization of our anticipated product candidates;

and the availability of alternative therapies for our target market. In some cases, you can identify forward -looking statements by terms such as “may,” “will,” “could,”

“should,” “would,” “anticipate,” “demonstrate,” “believe,” “estimate,” “continue,” “design,” “expect,” “intend,” “plan,” “pot ential,” “predict,” “seek” or the negative of

these words and similar expressions and their variants may identify forward -looking statements.

These forward -looking statements reflect management’s current expectations, are based on certain assumptions and involve certain risks and uncertainties, which

change over time. Our actual results may differ materially from these forward -looking statements due to various factors. Importa nt factors that may cause actual results

to differ materially from the results discussed in these forward -looking statements include, but are not limited to following s ummary risks, and detailed risk factors and