<SEC-DOCUMENT>0001193125-26-061399.txt : 20260220
<SEC-HEADER>0001193125-26-061399.hdr.sgml : 20260220
<ACCEPTANCE-DATETIME>20260220161706
ACCESSION NUMBER:		0001193125-26-061399
CONFORMED SUBMISSION TYPE:	4
PUBLIC DOCUMENT COUNT:		1
CONFORMED PERIOD OF REPORT:	20260219
FILED AS OF DATE:		20260220
DATE AS OF CHANGE:		20260220

REPORTING-OWNER:	

	OWNER DATA:	
		COMPANY CONFORMED NAME:			Cassella James V
		CENTRAL INDEX KEY:			0001353528
		ORGANIZATION NAME:           	

	FILING VALUES:
		FORM TYPE:		4
		SEC ACT:		1934 Act
		SEC FILE NUMBER:	001-38886
		FILM NUMBER:		26660162

	MAIL ADDRESS:	
		STREET 1:		C/O TREVI THERAPEUTICS INC
		CITY:			NEW HAVEN
		STATE:			CT
		ZIP:			06510

ISSUER:		

	COMPANY DATA:	
		COMPANY CONFORMED NAME:			Trevi Therapeutics, Inc.
		CENTRAL INDEX KEY:			0001563880
		STANDARD INDUSTRIAL CLASSIFICATION:	PHARMACEUTICAL PREPARATIONS [2834]
		ORGANIZATION NAME:           	03 Life Sciences
		EIN:				450834299
		STATE OF INCORPORATION:			DE
		FISCAL YEAR END:			1231

	BUSINESS ADDRESS:	
		STREET 1:		195 CHURCH STREET
		STREET 2:		16TH FLOOR
		CITY:			NEW HAVEN
		STATE:			CT
		ZIP:			06510
		BUSINESS PHONE:		203-304-2499

	MAIL ADDRESS:	
		STREET 1:		195 CHURCH STREET
		STREET 2:		16TH FLOOR
		CITY:			NEW HAVEN
		STATE:			CT
		ZIP:			06510
</SEC-HEADER>
<DOCUMENT>
<TYPE>4
<SEQUENCE>1
<FILENAME>ownership.xml
<DESCRIPTION>4
<TEXT>
<XML>
<?xml version="1.0"?>
<ownershipDocument>

    <schemaVersion>X0508</schemaVersion>

    <documentType>4</documentType>

    <periodOfReport>2026-02-19</periodOfReport>

    <issuer>
        <issuerCik>0001563880</issuerCik>
        <issuerName>Trevi Therapeutics, Inc.</issuerName>
        <issuerTradingSymbol>TRVI</issuerTradingSymbol>
    </issuer>

    <reportingOwner>
        <reportingOwnerId>
            <rptOwnerCik>0001353528</rptOwnerCik>
            <rptOwnerName>Cassella James V</rptOwnerName>
        </reportingOwnerId>
        <reportingOwnerAddress>
            <rptOwnerStreet1>C/O TREVI THERAPEUTICS, INC.</rptOwnerStreet1>
            <rptOwnerStreet2>195 CHURCH STREET, 16TH FLOOR</rptOwnerStreet2>
            <rptOwnerCity>NEW HAVEN</rptOwnerCity>
            <rptOwnerState>CT</rptOwnerState>
            <rptOwnerZipCode>06510</rptOwnerZipCode>
            <rptOwnerStateDescription></rptOwnerStateDescription>
        </reportingOwnerAddress>
        <reportingOwnerRelationship>
            <isDirector>false</isDirector>
            <isOfficer>true</isOfficer>
            <isTenPercentOwner>false</isTenPercentOwner>
            <isOther>false</isOther>
            <officerTitle>Chief Development Officer</officerTitle>
        </reportingOwnerRelationship>
    </reportingOwner>

    <aff10b5One>false</aff10b5One>

    <derivativeTable>
        <derivativeTransaction>
            <securityTitle>
                <value>Stock Option (right to buy)</value>
            </securityTitle>
            <conversionOrExercisePrice>
                <value>10.56</value>
            </conversionOrExercisePrice>
            <transactionDate>
                <value>2026-02-19</value>
            </transactionDate>
            <transactionCoding>
                <transactionFormType>4</transactionFormType>
                <transactionCode>A</transactionCode>
                <equitySwapInvolved>false</equitySwapInvolved>
            </transactionCoding>
            <transactionAmounts>
                <transactionShares>
                    <value>215000</value>
                </transactionShares>
                <transactionPricePerShare>
                    <value>0</value>
                </transactionPricePerShare>
                <transactionAcquiredDisposedCode>
                    <value>A</value>
                </transactionAcquiredDisposedCode>
            </transactionAmounts>
            <exerciseDate>
                <footnoteId id="F1"/>
            </exerciseDate>
            <expirationDate>
                <value>2036-02-18</value>
            </expirationDate>
            <underlyingSecurity>
                <underlyingSecurityTitle>
                    <value>Common Stock</value>
                </underlyingSecurityTitle>
                <underlyingSecurityShares>
                    <value>215000</value>
                </underlyingSecurityShares>
            </underlyingSecurity>
            <postTransactionAmounts>
                <sharesOwnedFollowingTransaction>
                    <value>215000</value>
                </sharesOwnedFollowingTransaction>
            </postTransactionAmounts>
            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>D</value>
                </directOrIndirectOwnership>
            </ownershipNature>
        </derivativeTransaction>
    </derivativeTable>

    <footnotes>
        <footnote id="F1">This option was granted on February 19, 2026. The 215,000 shares of common stock underlying the option are scheduled to vest in equal monthly installments through February 19, 2030, subject to the reporting person's continued service with the issuer.</footnote>
    </footnotes>

    <ownerSignature>
        <signatureName>/s/ Christopher Galletta, attorney-in-fact</signatureName>
        <signatureDate>2026-02-20</signatureDate>
    </ownerSignature>
</ownershipDocument>
</XML>
</TEXT>
</DOCUMENT>
</SEC-DOCUMENT>
