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Avenue Therapeutics, Inc.

1111 Kane Concourse, Suite 301

Bay Harbor Islands, Florida 33154

VIA EDGAR

January 30, 2024

Securities and Exchange Commission

Division of Corporation Finance

Office of Life Sciences

100 F Street, N.E.

Washington, D.C. 20549

Attn: Tamika Sheppard

  Re:
  Avenue Therapeutics, Inc.

Registration Statement
on Form S-3 (Reg. No. 333-276671)

Request for Acceleration of Effective Date

Ladies and Gentlemen:

Pursuant to Rule 461 under
the Securities Act of 1933, as amended, Avenue Therapeutics, Inc. (the “Company”) hereby requests that the Securities
and Exchange Commission (the “Commission”) accelerate the effective date of the above-referenced Registration Statement
on Form S-3 (the “Registration Statement”) so that the Registration Statement will be declared effective as of 5:00
p.m. Eastern time, on February 1, 2024, or as soon as practicable thereafter. The Company hereby authorizes Rakesh Gopalan or David Wolpa,
both of whom are attorneys at the Company’s outside legal counsel, Troutman Pepper Hamilton Sanders LLP, to orally modify or withdraw
this request for acceleration.

Once the Registration Statement
has been declared effective, please orally confirm that event with Mr. Gopalan at (704) 916-2374 or Mr. Wolpa at (704) 916-2375.

Thank you for your assistance
in this matter.

    Very
    truly yours,

    Avenue
    Therapeutics, Inc.

    /s/
    Alexandra MacLean

    Name:
    Alexandra MacLean

    Title:
    Chief Executive Officer

  cc (via email):
  Rakesh Gopalan and David Wolpa, Troutman Pepper Hamilton Sanders LLP