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                             December 21, 2020

       Jason Meggs
       Chief Financial Officer
       Syneos Health, Inc.
       1030 Sync Street
       North Carolina 27560-5468

                                                        Re: Syneos Health, Inc.
                                                            Form 10-K for
Fiscal Year Ended December 31, 2019
                                                            Filed February 20,
2020
                                                            Form 8-K Furnished
October 29, 2020
                                                            File No. 001-36730

       Dear Mr. Meggs:

              We have reviewed your filings and have the following comments. In
some of our
       comments, we may ask you to provide us with information so we may better
understand your
       disclosure.

              Please respond to these comments within ten business days by
providing the requested
       information or advise us as soon as possible when you will respond. If
you do not believe our
       comments apply to your facts and circumstances, please tell us why in
your response.

                                                        After reviewing your
response to these comments, we may have additional comments.

       Form 10-K for Fiscal Year Ended December 31, 2019

       Notes to Consolidated Financial Statements
       Note 1. Basis of Presentation and Summary of Significant Accounting
Policies
       Cash and Cash Equivalents, page 91

   1.                                                   We note that certain of
your subsidiaries participate in a notional cash pooling
                                                        arrangement to manage
global liquidity requirements. The parties to the arrangement
                                                        combine their cash
balances in pooling accounts with the ability to offset bank overdrafts
                                                        of one subsidiary
against positive cash account balances maintained in another
                                                        subsidiary   s bank
account at the same financial institution. Please tell us whether you
                                                        intend to and have set
off such amounts with the counterparty. Refer to ASC 210-20-45-1
                                                        to 5.
 Jason Meggs
FirstName LastNameJason   Meggs
Syneos Health, Inc.
Comapany21,
December  NameSyneos
              2020     Health, Inc.
December
Page 2    21, 2020 Page 2
FirstName LastName
Revenue Recognition, page 96

2.       We note the majority of your Clinical Solutions segment revenue is for
service offerings
         that range in duration from a few months to several years and
typically represent a single
         performance obligation. Revenue is recognized over time using costs
incurred to date
         relative to total estimated costs to complete (   cost-to-cost measure
of progress   ). We also
         note the estimate of total revenue and costs to completion requires
significant judgment.
         Contract estimates are based on various assumptions to project future
outcomes of events
         that often span several years, as well on evaluations and updates made
on an ongoing
         basis. These estimates are reviewed periodically and any adjustments
are recognized on a
         cumulative catch up basis in the period they become known. Updates and
adjustments to
         estimates are likely to result in variability in revenue recognized
from period to period and
         may cause unexpected variability in our operating results.

         Please tell us and quantify in the notes to your financial statements
in annual and quarterly
         reports the aggregate amount and related earnings per share impact of
changes in contract
         estimates for each period presented. Refer to ASC 250-10-50-4 and
270-10-45-14 for
         guidance. Please also revise your results of operations disclosure in
MD&A to separately
         quantify gross favorable and gross unfavorable changes in estimates
material to either
         consolidated or segment results, accompanied by an appropriate level
of analysis. Please
         provide us with your intended revised disclosure.
12. Revenue from Contracts with Customers, page 128

3.       Please tell us your consideration of providing disaggregated revenue
from contracts with
         customers pursuant to ASC 606-10-50-5 and 55-89 through 55-91. In this
regard, we note
         from your disclosures on page 9 to 15 and page 60 that you provide
multiple service
         offerings.
Exhibits

4.       We note that Article XI, Section 11.1 of your Amended and Restated
Certificate of
         Incorporation provides that the Court of Chancery of the State of
Delaware is the sole and
         exclusive forum for    any derivative action or proceeding brought on
behalf of the
         Corporation.    In future filings, please clearly describe the
provision in your disclosure,
         including any risks or other impact on investors related to the
provision. Risks may
         include, but are not limited to, increased costs to bring a claim and
that these provisions
         can discourage claims or limit investors' ability to bring a claim in
a judicial forum that
         they find favorable. Please also tell us, and disclose in future
filings, whether this
         provision applies to actions arising under the Exchange Act and/or the
Securities Act. In
         this regard, we note that Section 27 of the Exchange Act creates
exclusive federal
         jurisdiction over all suits brought to enforce any duty or liability
created by the Exchange
         Act or the rules and regulations thereunder. We also note that Section
22 of the Securities
         Act creates concurrent jurisdiction for federal and state courts over
all suits brought to
 Jason Meggs
Syneos Health, Inc.
December 21, 2020
Page 3
         enforce any duty or liability created by the Securities Act or the
rules and regulations
         thereunder. If the provision applies to Securities Act claims, please
also disclose in future
         filings that there is uncertainty as to whether a court would enforce
such provision and
         that investors cannot waive compliance with the federal securities
laws and the rules and
         regulations thereunder.
Form 8-K Furnished October 29, 2020

Exhibit 99.1
Highlights, page 1

5.       We note the following in regards to your presentation of non-GAAP
financial measures in
         the "Highlights" section of your earnings release:

                Discussion is provided regarding Q3 growth of your "Adjusted
diluted earnings per
              share" and "Adjusted EBITDA" measures without providing similar
discussion for
              the comparable GAAP measure;
                Presentation is provided of your "Adjusted EBITDA margin"
without providing
              similar presentation of the comparable GAAP measure;
                In the second to last bullet point, you highlight your
"adjusted EBITDA" and
              "adjusted diluted earnings per share" guidance without providing
comparable GAAP
              guidance.

         When presenting non-GAAP measures in your earnings release, please
present the
         most directly comparable GAAP measure with equal or greater
prominence. Refer to
         Item 10(e)(1)(i)(A) of Regulation S-K and Question 102.10 of the
staff's Compliance
         and Disclosure Interpretation on Non-GAAP Financial Measures ("C&DI
s").

        We remind you that the company and its management are responsible for
the accuracy
and adequacy of their disclosures, notwithstanding any review, comments, action
or absence of
action by the staff.

       You may contact Abe Friedman at 202-551-8298 or Lyn Shenk at
202-551-3380 if you
have questions regarding comments on the financial statements and related
matters. Please
contact Nicholas Lamparski at 202-551-4695 or Dietrich King at 202-551-8071
with any other
questions.



FirstName LastNameJason Meggs                                   Sincerely,
Comapany NameSyneos Health, Inc.
                                                                Division of
Corporation Finance
December 21, 2020 Page 3                                        Office of Trade
& Services
FirstName LastName