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UNITED STATES SECURITIES AND EXCHANGE COMMISSION WASHINGTON , DC 20549 ANNUAL REPORT PURSUANT TO SECTION 13 OR 15 ( d ) OF THE SECURITIES EXCHANGE ACT OF 1934 For the fiscal year ended December 31 , 2020 or TRANSITION REPORT PURSUANT TO SECTION 13 OR 15 ( d ) OF THE SECURITIES EXCHANGE ACT OF 1934 For the transition period from to Commission File Number : 001-35068 Delaware ( State or other jurisdiction of incorporation or organization ) Title of Each Class Common Stock , $ 0.001 par value FORM 10 - K ACELRX PHARMACEUTICALS , INC . ( Exact name of registrant as specified in its charter ) 351 Galveston Drive Redwood City , CA 94063 ( 650 ) 216-3500 ( Address , including zip code , and telephone number , including area code , of registrant's principal executive offices ) Securities registered pursuant to Section 12 ( b ) of the Act : ✓ Trading Symbol ( s ) . 41-2193603 ( IRS Employer Identification No. ) ACRX Name of Each Exchange on Which Registered The Nasdaq Global Market Securities registered pursuant to Section 12 ( g ) of the Act : None Indicate by check mark if the registrant is a well - known seasoned issuer , as defined in Rule 405 of the Securities Act . Yes No Indicate by check mark if the registrant is not required to file reports pursuant to Section 13 or Section 15 ( d ) of the Act . Yes No Indicate by check mark whether the registrant ( 1 ) has filed all reports required to be filed by Section 13 or 15 ( d ) of the Securities Exchange Act of 1934 during the preceding 12 months ( or for such shorter period that the registrant was required to file such reports ) , and ( 2 ) has been subject to such filing requirements for the past 90 days . Yes No Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S - T ( § - 232.405 of this chapter ) during the preceding 12 months ( or for such shorter period that the registrant was required to submit such files ) . Yes No Indicate by check mark whether the registrant is a large accelerated filer , an accelerated filer , a non - accelerated filer , a smaller reporting company , or an emerging growth company . See the definitions of " large accelerated filer , " " accelerated filer , " " smaller reporting company , ” and “ emerging growth company " in Rule 12b - 2 of the Exchange Act . Large accelerated filer Non - accelerated filer Accelerated filer Smaller reporting company 四 口 Emerging growth company If an emerging growth company , indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13 ( a ) of the Exchange Act . Indicate by check mark whether the registrant has filed a report on and attestation to its management's assessment of the effectiveness of its internal control over financial reporting under Section 404 ( b ) of the Sarbanes - Oxley Act ( 15 U.S.C. 7262 ( b ) ) by the registered public accounting firm that prepared or issued its audit report . Indicate by check mark whether the registrant is a shell company ( as defined in Exchange Act Rule 12b - 2 ) Yes No ✔ The aggregate market value of the voting stock held by non - affiliates of the registrant on June 30 , 2020 ( the last business day of the registrant's most recently completed second fiscal quarter ) , based upon the last sale price reported on the Nasdaq Global Market on that date , was approximately $ 95,491,775 . The calculation excludes 1,971,363 shares of the registrant's common stock held by current executive officers and directors that the registrant has concluded are affiliates of the registrant . Exclusion of such shares should not be construed to indicate that any such person possesses the power , direct or indirect , to direct or cause the direction of the management or policies of the registrant or that such person is controlled by or under common control with the registrant . As of March 9 , 2021 , the number of outstanding shares of the registrant's common stock was 118,947,830 . DOCUMENTS INCORPORATED BY REFERENCE