The Securities and Exchange Commission has not necessarily reviewed the information in this filing and has not determined if it is accurate and complete.
The reader should not assume that the information is accurate and complete.

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 13F

FORM 13F COVER PAGE

OMB APPROVAL
OMB Number: 3235-0006
Expires: July 31, 2015
Estimated average burden
hours per response: 23.8

Report for the Calendar Year or Quarter Ended: 03-31-2021
Check here if Amendment   Amendment Number:
This Amendment (Check only one.):   is a restatement.
  adds new holdings entries.
Institutional Investment Manager Filing this Report:
Name: Ghost Tree Capital, LLC
Address: 667 MADISON AVENUE
5TH FLOOR, SUITE 12
NEW YORK , NY10065
Form 13F File Number: 028-16059

The institutional investment manager filing this report and the person by whom it is signed hereby represent that the person signing the report is authorized to submit it, that all information contained herein is true, correct and complete, and that it is understood that all required items, statements, schedules, lists, and tables, are considered integral parts of this form.

Person Signing this Report on Behalf of Reporting Manager:
Name: MATTHEW JAMES DIAZ
Title: CHIEF COMPLIANCE OFFICER
Phone: 6467790121
Signature, Place, and Date of Signing:
MATTHEW JAMES DIAZ, CHIEF COMPLIANCE OFFICER NEW YORK , NY 05-14-2021
[Signature] [City, State] [Date]
Report Type (Check only one.):
X 13F HOLDINGS REPORT. (Check here if all holdings of this reporting manager are reported in this report.)
  13F NOTICE. (Check here if no holdings reported are in this report, and all holdings are reported by other reporting manager(s).)
  13F COMBINATION REPORT. (Check here if a portion of the holdings for this reporting manager are reported in this report and a portion are reported by other reporting manager(s).)
Form 13F Summary Page
Report Summary:
Number of Other Included Managers: 0
Form 13F Information Table Entry Total: 50
Form 13F Information Table Value Total: 425,474
(thousands)
List of Other Managers Reporting for this Manager:
[If there are no entries in this list, omit this section.]
Form 13F File Number Name

List of Other Included Managers:
Provide a numbered list of the name(s) and Form 13F file number(s) of all institutional investment managers with respect to which this report is filed, other than the manager filing this report.
[If there are no entries in this list, state “NONE” and omit the column headings and list entries.]
No. Form 13F File Number Name


SEC FORM 13F-HR

The Securities and Exchange Commission has not necessarily reviewed the information in this filing and has not determined if it is accurate and complete.
The reader should not assume that the information is accurate and complete.

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 13F

FORM 13F INFORMATION TABLE

OMB APPROVAL
OMB Number: 3235-0006
Expires: July 31, 2015
Estimated average burden
hours per response: 23.8

COLUMN 1 COLUMN 2 COLUMN 3 COLUMN 4 COLUMN 5 COLUMN 6 COLUMN 7 COLUMN 8
VALUE SHRS OR SH/ PUT/ INVESTMENT OTHER VOTING AUTHORITY
NAME OF ISSUER TITLE OF CLASS CUSIP (x$1000) PRN AMT PRN CALL DISCRETION MANAGER SOLE SHARED NONE
ACLARIS THERAPEUTICS INC COM 00461U105 15,120 600,000 SH SOLE 15,120 0 0
ALDEYRA THERAPEUTICS INC COM 01438T106 7,722 650,000 SH SOLE 7,722 0 0
AMICUS THERAPEUTICS INC COM 03152W109 2,618 265,000 SH SOLE 2,618 0 0
APELLIS PHARMACEUTICALS INC COM 03753U106 9,655 225,000 SH SOLE 9,655 0 0
APTEVO THERAPEUTICS INC COM NEW 03835L207 1,526 50,000 SH SOLE 1,526 0 0
ARK ETF TR GENOMIC REV ETF 00214Q302 17,746 200,000 SH Put SOLE 17,746 0 0
ARVINAS INC COM 04335A105 13,551 205,000 SH SOLE 13,551 0 0
ASCENDIS PHARMA A/S SPONSORED ADR 04351P101 17,399 135,000 SH SOLE 17,399 0 0
BICYCLE THERAPEUTICS PLC SPONSORED ADS 088786108 4,481 150,000 SH SOLE 4,481 0 0
BIOCRYST PHARMACEUTICALS INC COM 09058V103 5,085 500,000 SH SOLE 5,085 0 0
BIOGEN INC COM 09062X103 5,595 20,000 SH SOLE 5,595 0 0
CASI PHARMACEUTICALS INC COM 14757U109 1,560 650,000 SH SOLE 1,560 0 0
CATALYST BIOSCIENCES INC COM NEW 14888D208 5,040 1,000,000 SH SOLE 5,040 0 0
CELLDEX THERAPEUTICS INC NEW COM NEW 15117B202 2,060 100,000 SH Put SOLE 2,060 0 0
CELLDEX THERAPEUTICS INC NEW COM NEW 15117B202 5,150 250,000 SH SOLE 5,150 0 0
CHIMERIX INC COM 16934W106 1,928 200,000 SH SOLE 1,928 0 0
COGENT BIOSCIENCES INC COM 19240Q201 14,048 1,600,000 SH SOLE 14,048 0 0
CONSTELLATION PHARMCETICLS I COM 210373106 6,432 275,000 SH SOLE 6,432 0 0
CTI BIOPHARMA CORP COM 12648L601 2,183 750,000 SH SOLE 2,183 0 0
CURIS INC COM NEW 231269200 4,811 425,000 SH SOLE 4,811 0 0
ESSA PHARMA INC COM NEW 29668H708 5,084 175,000 SH SOLE 5,084 0 0
FATE THERAPEUTICS INC COM 31189P102 15,253 185,000 SH SOLE 15,253 0 0
FIBROGEN INC COM 31572Q808 4,339 125,000 SH SOLE 4,339 0 0
FREQUENCY THERAPEUTICS INC COM 35803L108 950 100,000 SH Put SOLE 950 0 0
HELIX ACQUISITION CORP COM CL A G4444C102 5,118 500,000 SH SOLE 5,118 0 0
IMMUNIC INC COM 4525EP101 4,224 265,000 SH SOLE 4,224 0 0
IMMUNOVANT INC COM 45258J102 4,010 250,000 SH SOLE 4,010 0 0
INVESCO QQQ TR UNIT SER 1 46090E103 47,870 150,000 SH Put SOLE 47,870 0 0
IOVANCE BIOTHERAPEUTICS INC COM 462260100 15,830 500,000 SH SOLE 15,830 0 0
ISHARES TR RUSSELL 2000 ETF 464287655 6,628 30,000 SH SOLE 6,628 0 0
IVERIC BIO INC COM 46583P102 6,953 1,125,000 SH SOLE 6,953 0 0
KADMON HLDGS INC COM 48283N106 2,334 600,000 SH SOLE 2,334 0 0
KURA ONCOLOGY INC COM 50127T109 16,962 600,000 SH SOLE 16,962 0 0
MERSANA THERAPEUTICS INC COM 59045L106 7,281 450,000 SH SOLE 7,281 0 0
MIRATI THERAPEUTICS INC COM 60468T105 8,565 50,000 SH SOLE 8,565 0 0
NOVAVAX INC COM NEW 670002401 3,173 17,500 SH SOLE 3,173 0 0
NUVATION BIO INC COM CL A 67080N101 4,964 500,000 SH SOLE 4,964 0 0
OTONOMY INC COM 68906L105 1,148 450,000 SH SOLE 1,148 0 0
PRECISION BIOSCIENCES INC COM 74019P108 2,070 200,000 SH SOLE 2,070 0 0
ROCKET PHARMACEUTICALS INC COM 77313F106 14,420 325,000 SH SOLE 14,420 0 0
SAGE THERAPEUTICS INC COM 78667J108 2,246 30,000 SH SOLE 2,246 0 0
SATSUMA PHARMACEUTICALS INC COM 80405P107 5,136 904,225 SH SOLE 5,136 0 0
SIERRA ONCOLOGY INC COM NEW 82640U404 3,446 200,000 SH SOLE 3,446 0 0
SYNDAX PHARMACEUTICALS INC COM 87164F105 26,273 1,175,000 SH SOLE 26,273 0 0
TG THERAPEUTICS INC COM 88322Q108 9,640 200,000 SH SOLE 9,640 0 0
TRILLIUM THERAPEUTICS INC COM NEW 89620X506 20,943 1,950,000 SH SOLE 20,943 0 0
VERONA PHARMA PLC SPONSORED ADS 925050106 7,850 939,043 SH SOLE 7,850 0 0
VIRIDIAN THERAPEUTICS INC COM 92790C104 5,013 300,000 SH SOLE 5,013 0 0
VISTAGEN THERAPEUTICS INC COM NEW 92840H202 8,826 4,143,702 SH SOLE 8,826 0 0
XENON PHARMACEUTICALS INC COM 98420N105 15,215 850,000 SH SOLE 15,215 0 0