<SEC-DOCUMENT>0001140361-16-088218.txt : 20161130
<SEC-HEADER>0001140361-16-088218.hdr.sgml : 20161130
<ACCEPTANCE-DATETIME>20161130152934
ACCESSION NUMBER:		0001140361-16-088218
CONFORMED SUBMISSION TYPE:	3
PUBLIC DOCUMENT COUNT:		1
CONFORMED PERIOD OF REPORT:	20161128
FILED AS OF DATE:		20161130
DATE AS OF CHANGE:		20161130

ISSUER:		

	COMPANY DATA:	
		COMPANY CONFORMED NAME:			Microbot Medical Inc.
		CENTRAL INDEX KEY:			0000883975
		STANDARD INDUSTRIAL CLASSIFICATION:	BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836]
		IRS NUMBER:				943078125
		STATE OF INCORPORATION:			DE
		FISCAL YEAR END:			1231

	BUSINESS ADDRESS:	
		STREET 1:		175 DERBY ST. 27/1
		STREET 2:		.
		CITY:			HINGHAM
		STATE:			MA
		ZIP:			02043
		BUSINESS PHONE:		908-938-5561

	MAIL ADDRESS:	
		STREET 1:		175 DERBY ST. 27/1
		STREET 2:		.
		CITY:			HINGHAM
		STATE:			MA
		ZIP:			02043

	FORMER COMPANY:	
		FORMER CONFORMED NAME:	STEMCELLS INC
		DATE OF NAME CHANGE:	20000524

	FORMER COMPANY:	
		FORMER CONFORMED NAME:	CYTOTHERAPEUTICS INC/DE
		DATE OF NAME CHANGE:	19930328

REPORTING-OWNER:	

	OWNER DATA:	
		COMPANY CONFORMED NAME:			Berkson Sandra
		CENTRAL INDEX KEY:			0001690757

	FILING VALUES:
		FORM TYPE:		3
		SEC ACT:		1934 Act
		SEC FILE NUMBER:	000-19871
		FILM NUMBER:		162025188

	MAIL ADDRESS:	
		STREET 1:		C/O SABER HOLDING GMBH
		CITY:			WEIN KRUMMBAUMGASSE
		STATE:			C4
		ZIP:			1020

REPORTING-OWNER:	

	OWNER DATA:	
		COMPANY CONFORMED NAME:			Berkson Avram
		CENTRAL INDEX KEY:			0001690753

	FILING VALUES:
		FORM TYPE:		3
		SEC ACT:		1934 Act
		SEC FILE NUMBER:	000-19871
		FILM NUMBER:		162025189

	MAIL ADDRESS:	
		STREET 1:		C/O SABER HOLDING GMBH
		CITY:			WIEN KRUMMBAUMGASSE
		STATE:			C4
		ZIP:			1020
</SEC-HEADER>
<DOCUMENT>
<TYPE>3
<SEQUENCE>1
<FILENAME>doc1.xml
<DESCRIPTION>FORM 3
<TEXT>
<XML>
<?xml version="1.0"?>
<ownershipDocument>

    <schemaVersion>X0206</schemaVersion>

    <documentType>3</documentType>

    <periodOfReport>2016-11-28</periodOfReport>

    <noSecuritiesOwned>0</noSecuritiesOwned>

    <issuer>
        <issuerCik>0000883975</issuerCik>
        <issuerName>Microbot Medical Inc.</issuerName>
        <issuerTradingSymbol>MBOT</issuerTradingSymbol>
    </issuer>

    <reportingOwner>
        <reportingOwnerId>
            <rptOwnerCik>0001690753</rptOwnerCik>
            <rptOwnerName>Berkson Avram</rptOwnerName>
        </reportingOwnerId>
        <reportingOwnerAddress>
            <rptOwnerStreet1>C/O SABER HOLDING GMBH</rptOwnerStreet1>
            <rptOwnerStreet2></rptOwnerStreet2>
            <rptOwnerCity>WIEN KRUMMBAUMGASSE</rptOwnerCity>
            <rptOwnerState>C4</rptOwnerState>
            <rptOwnerZipCode>1020</rptOwnerZipCode>
            <rptOwnerStateDescription>AUSTRIA</rptOwnerStateDescription>
        </reportingOwnerAddress>
        <reportingOwnerRelationship>
            <isDirector>0</isDirector>
            <isOfficer>0</isOfficer>
            <isTenPercentOwner>1</isTenPercentOwner>
            <isOther>0</isOther>
            <officerTitle></officerTitle>
            <otherText></otherText>
        </reportingOwnerRelationship>
    </reportingOwner>

    <reportingOwner>
        <reportingOwnerId>
            <rptOwnerCik>0001690757</rptOwnerCik>
            <rptOwnerName>Berkson Sandra</rptOwnerName>
        </reportingOwnerId>
        <reportingOwnerAddress>
            <rptOwnerStreet1>C/O SABER HOLDING GMBH</rptOwnerStreet1>
            <rptOwnerStreet2></rptOwnerStreet2>
            <rptOwnerCity>WIEN KRUMMBAUMGASSE</rptOwnerCity>
            <rptOwnerState>C4</rptOwnerState>
            <rptOwnerZipCode>1020</rptOwnerZipCode>
            <rptOwnerStateDescription>AUSTRIA</rptOwnerStateDescription>
        </reportingOwnerAddress>
        <reportingOwnerRelationship>
            <isDirector>0</isDirector>
            <isOfficer>0</isOfficer>
            <isTenPercentOwner>1</isTenPercentOwner>
            <isOther>0</isOther>
            <officerTitle></officerTitle>
            <otherText></otherText>
        </reportingOwnerRelationship>
    </reportingOwner>

    <nonDerivativeTable>
        <nonDerivativeHolding>
            <securityTitle>
                <value>Common Stock, par value $0.01 per share</value>
            </securityTitle>
            <postTransactionAmounts>
                <sharesOwnedFollowingTransaction>
                    <value>4307003</value>
                    <footnoteId id="F1"/>
                </sharesOwnedFollowingTransaction>
            </postTransactionAmounts>
            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>D</value>
                </directOrIndirectOwnership>
            </ownershipNature>
        </nonDerivativeHolding>
    </nonDerivativeTable>

    <derivativeTable></derivativeTable>

    <footnotes>
        <footnote id="F1">Avram Berkson and Sandra Berkson may be deemed to share voting and investment power over the shares beneficially owned by this entity.</footnote>
    </footnotes>

    <ownerSignature>
        <signatureName>/s/ Avram Berkson</signatureName>
        <signatureDate>2016-11-30</signatureDate>
    </ownerSignature>

    <ownerSignature>
        <signatureName>/s/ Sandra Berkson</signatureName>
        <signatureDate>2016-11-30</signatureDate>
    </ownerSignature>
</ownershipDocument>
</XML>
</TEXT>
</DOCUMENT>
</SEC-DOCUMENT>
