<?xml version="1.0"?>
<ownershipDocument>

    <schemaVersion>X0609</schemaVersion>

    <documentType>4</documentType>

    <periodOfReport>2026-09-30</periodOfReport>

    <issuer>
        <issuerCik>0001739104</issuerCik>
        <issuerName>Elanco Animal Health Inc</issuerName>
        <issuerTradingSymbol>ELAN</issuerTradingSymbol>
        <issuerForeignTradingSymbol></issuerForeignTradingSymbol>
    </issuer>

    <reportingOwner>
        <reportingOwnerId>
            <rptOwnerCik>0001679166</rptOwnerCik>
            <rptOwnerName>Anand Kapila K</rptOwnerName>
        </reportingOwnerId>
        <reportingOwnerAddress>
            <rptOwnerNonUSAddressFlag>false</rptOwnerNonUSAddressFlag>
            <rptOwnerStreet1>C/O ELANCO ANIMAL HEALTH INCORPORATED</rptOwnerStreet1>
            <rptOwnerStreet2>450 ELANCO CIRCLE</rptOwnerStreet2>
            <rptOwnerCity>INDIANAPOLIS</rptOwnerCity>
            <rptOwnerState>IN</rptOwnerState>
            <rptOwnerZipCode>46221</rptOwnerZipCode>
            <rptOwnerStateDescription></rptOwnerStateDescription>
        </reportingOwnerAddress>
        <reportingOwnerRelationship>
            <isDirector>true</isDirector>
            <isOfficer>false</isOfficer>
            <isTenPercentOwner>false</isTenPercentOwner>
            <isOther>false</isOther>
            <officerTitle></officerTitle>
            <otherText></otherText>
        </reportingOwnerRelationship>
    </reportingOwner>

    <aff10b5One>0</aff10b5One>

    <nonDerivativeTable></nonDerivativeTable>

    <derivativeTable>
        <derivativeTransaction>
            <securityTitle>
                <value>Deferred Stock Units</value>
                <footnoteId id="F1"/>
                <footnoteId id="F2"/>
            </securityTitle>
            <conversionOrExercisePrice>
                <footnoteId id="F3"/>
            </conversionOrExercisePrice>
            <transactionDate>
                <value>2026-09-30</value>
            </transactionDate>
            <transactionCoding>
                <transactionFormType>4</transactionFormType>
                <transactionCode>A</transactionCode>
                <equitySwapInvolved>0</equitySwapInvolved>
            </transactionCoding>
            <transactionAmounts>
                <transactionShares>
                    <value>642.0277</value>
                </transactionShares>
                <transactionPricePerShare>
                    <value>22.39</value>
                    <footnoteId id="F2"/>
                    <footnoteId id="F3"/>
                </transactionPricePerShare>
                <transactionAcquiredDisposedCode>
                    <value>A</value>
                </transactionAcquiredDisposedCode>
            </transactionAmounts>
            <exerciseDate>
                <footnoteId id="F1"/>
            </exerciseDate>
            <expirationDate>
                <footnoteId id="F1"/>
            </expirationDate>
            <underlyingSecurity>
                <underlyingSecurityTitle>
                    <value>Common Stock</value>
                </underlyingSecurityTitle>
                <underlyingSecurityShares>
                    <value>642.0277</value>
                </underlyingSecurityShares>
            </underlyingSecurity>
            <postTransactionAmounts>
                <sharesOwnedFollowingTransaction>
                    <value>10721.5916</value>
                </sharesOwnedFollowingTransaction>
            </postTransactionAmounts>
            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>D</value>
                </directOrIndirectOwnership>
                <natureOfOwnership>
                    <value></value>
                </natureOfOwnership>
            </ownershipNature>
        </derivativeTransaction>
    </derivativeTable>

    <footnotes>
        <footnote id="F1">Ms. Anand elected to defer her director cash retainer fees pursuant to the Company's Directors' Deferral Plan (the &quot;Plan&quot;) and such deferred fees were credited to the Elanco Deferred Stock Account under the Plan. Each Deferred Stock Unit is the economic equivalent of one share of Elanco common stock.</footnote>
        <footnote id="F2">The Deferred Stock Units will be settled in stock upon the reporting person's separation of service from the Company's Board of Directors pursuant to the Plan.</footnote>
        <footnote id="F3">The number of Deferred Stock Units issued is the amount of cash compensation deferred divided by the closing price of a share of Elanco common stock on the grant date, which was $24.61 on September 30, 2026.</footnote>
    </footnotes>

    <ownerSignature>
        <signatureName>/s/ Amy C. Seidel, as Attorney-in-Fact for Kapila K. Anand</signatureName>
        <signatureDate>2026-10-01</signatureDate>
    </ownerSignature>
</ownershipDocument>
