<?xml version="1.0" encoding="US-ASCII" standalone="no"?>
<!--Generated by ThunderDome XBRL - 02:20AM UTC 2025-02-28--><link:linkbase xmlns:link="http://www.xbrl.org/2003/linkbase" xmlns:xbrldt="http://xbrl.org/2005/xbrldt" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.xbrl.org/2003/linkbase http://www.xbrl.org/2003/xbrl-linkbase-2003-12-31.xsd">
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-note-14-litigation-" xlink:href="hstm-20241231.xsd#statement-note-14-litigation-" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-note-14-litigation-" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_NotesToFinancialStatementsAbstract" xlink:label="hstm_NotesToFinancialStatementsAbstract" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_CommitmentsAndContingenciesDisclosureTextBlock" xlink:label="us-gaap_CommitmentsAndContingenciesDisclosureTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DisclosureTextBlockAbstract" xlink:label="us-gaap_DisclosureTextBlockAbstract" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DisclosureTextBlockAbstract" xlink:label="us-gaap_DisclosureTextBlockAbstract-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_NotesToFinancialStatementsAbstract" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_DisclosureTextBlockAbstract-2" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DisclosureTextBlockAbstract" xlink:to="us-gaap_CommitmentsAndContingenciesDisclosureTextBlock" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-note-4-marketable-securities" xlink:href="hstm-20241231.xsd#statement-note-4-marketable-securities" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-note-4-marketable-securities" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_NotesToFinancialStatementsAbstract" xlink:label="hstm_NotesToFinancialStatementsAbstract" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DisclosureTextBlockAbstract" xlink:label="us-gaap_DisclosureTextBlockAbstract" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DisclosureTextBlockAbstract" xlink:label="us-gaap_DisclosureTextBlockAbstract-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_InvestmentsInDebtAndMarketableEquitySecuritiesAndCertainTradingAssetsDisclosureTextBlock" xlink:label="us-gaap_InvestmentsInDebtAndMarketableEquitySecuritiesAndCertainTradingAssetsDisclosureTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_NotesToFinancialStatementsAbstract" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_DisclosureTextBlockAbstract-2" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DisclosureTextBlockAbstract" xlink:to="us-gaap_InvestmentsInDebtAndMarketableEquitySecuritiesAndCertainTradingAssetsDisclosureTextBlock" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-document-and-entity-information" xlink:href="hstm-20241231.xsd#statement-document-and-entity-information" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-document-and-entity-information" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_AmendmentFlag" xlink:label="dei_AmendmentFlag" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_AuditorFirmId" xlink:label="dei_AuditorFirmId" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_AuditorLocation" xlink:label="dei_AuditorLocation" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_AuditorName" xlink:label="dei_AuditorName" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_CityAreaCode" xlink:label="dei_CityAreaCode" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_CurrentFiscalYearEndDate" xlink:label="dei_CurrentFiscalYearEndDate" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_DocumentAnnualReport" xlink:label="dei_DocumentAnnualReport" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_DocumentFinStmtErrorCorrectionFlag" xlink:label="dei_DocumentFinStmtErrorCorrectionFlag" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_DocumentFiscalPeriodFocus" xlink:label="dei_DocumentFiscalPeriodFocus" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_DocumentFiscalYearFocus" xlink:label="dei_DocumentFiscalYearFocus" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_DocumentInformationLineItems" xlink:label="dei_DocumentInformationLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_DocumentInformationTable" xlink:label="dei_DocumentInformationTable" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_DocumentPeriodEndDate" xlink:label="dei_DocumentPeriodEndDate" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_DocumentTransitionReport" xlink:label="dei_DocumentTransitionReport" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_DocumentType" xlink:label="dei_DocumentType" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityAddressAddressLine1" xlink:label="dei_EntityAddressAddressLine1" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityAddressCityOrTown" xlink:label="dei_EntityAddressCityOrTown" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityAddressPostalZipCode" xlink:label="dei_EntityAddressPostalZipCode" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityAddressStateOrProvince" xlink:label="dei_EntityAddressStateOrProvince" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityCentralIndexKey" xlink:label="dei_EntityCentralIndexKey" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityCommonStockSharesOutstanding" xlink:label="dei_EntityCommonStockSharesOutstanding" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityCurrentReportingStatus" xlink:label="dei_EntityCurrentReportingStatus" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityEmergingGrowthCompany" xlink:label="dei_EntityEmergingGrowthCompany" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityFileNumber" xlink:label="dei_EntityFileNumber" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityFilerCategory" xlink:label="dei_EntityFilerCategory" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityIncorporationStateCountryCode" xlink:label="dei_EntityIncorporationStateCountryCode" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityInteractiveDataCurrent" xlink:label="dei_EntityInteractiveDataCurrent" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityPublicFloat" xlink:label="dei_EntityPublicFloat" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityRegistrantName" xlink:label="dei_EntityRegistrantName" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityShellCompany" xlink:label="dei_EntityShellCompany" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntitySmallBusiness" xlink:label="dei_EntitySmallBusiness" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityTaxIdentificationNumber" xlink:label="dei_EntityTaxIdentificationNumber" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityVoluntaryFilers" xlink:label="dei_EntityVoluntaryFilers" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityWellKnownSeasonedIssuer" xlink:label="dei_EntityWellKnownSeasonedIssuer" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_IcfrAuditorAttestationFlag" xlink:label="dei_IcfrAuditorAttestationFlag" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LocalPhoneNumber" xlink:label="dei_LocalPhoneNumber" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_Security12bTitle" xlink:label="dei_Security12bTitle" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_SecurityExchangeName" xlink:label="dei_SecurityExchangeName" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_TradingSymbol" xlink:label="dei_TradingSymbol" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationTable" xlink:to="dei_DocumentInformationLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_EntityCentralIndexKey" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_EntityRegistrantName" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_AmendmentFlag" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_CurrentFiscalYearEndDate" xlink:type="arc"/>
    <link:presentationArc order="4" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_DocumentFiscalPeriodFocus" xlink:type="arc"/>
    <link:presentationArc order="5" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_DocumentFiscalYearFocus" xlink:type="arc"/>
    <link:presentationArc order="6" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_DocumentType" xlink:type="arc"/>
    <link:presentationArc order="7" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_DocumentAnnualReport" xlink:type="arc"/>
    <link:presentationArc order="8" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_DocumentPeriodEndDate" xlink:type="arc"/>
    <link:presentationArc order="9" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_DocumentTransitionReport" xlink:type="arc"/>
    <link:presentationArc order="10" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_EntityFileNumber" xlink:type="arc"/>
    <link:presentationArc order="11" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_EntityIncorporationStateCountryCode" xlink:type="arc"/>
    <link:presentationArc order="12" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_EntityTaxIdentificationNumber" xlink:type="arc"/>
    <link:presentationArc order="13" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_EntityAddressAddressLine1" xlink:type="arc"/>
    <link:presentationArc order="14" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_EntityAddressPostalZipCode" xlink:type="arc"/>
    <link:presentationArc order="15" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_EntityAddressCityOrTown" xlink:type="arc"/>
    <link:presentationArc order="16" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_EntityAddressStateOrProvince" xlink:type="arc"/>
    <link:presentationArc order="17" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_CityAreaCode" xlink:type="arc"/>
    <link:presentationArc order="18" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_LocalPhoneNumber" xlink:type="arc"/>
    <link:presentationArc order="19" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_Security12bTitle" xlink:type="arc"/>
    <link:presentationArc order="20" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_TradingSymbol" xlink:type="arc"/>
    <link:presentationArc order="21" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_SecurityExchangeName" xlink:type="arc"/>
    <link:presentationArc order="22" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_EntityWellKnownSeasonedIssuer" xlink:type="arc"/>
    <link:presentationArc order="23" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_EntityVoluntaryFilers" xlink:type="arc"/>
    <link:presentationArc order="24" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_EntityCurrentReportingStatus" xlink:type="arc"/>
    <link:presentationArc order="25" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_EntityInteractiveDataCurrent" xlink:type="arc"/>
    <link:presentationArc order="26" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_EntityFilerCategory" xlink:type="arc"/>
    <link:presentationArc order="27" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_EntitySmallBusiness" xlink:type="arc"/>
    <link:presentationArc order="28" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_EntityEmergingGrowthCompany" xlink:type="arc"/>
    <link:presentationArc order="29" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_IcfrAuditorAttestationFlag" xlink:type="arc"/>
    <link:presentationArc order="30" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_DocumentFinStmtErrorCorrectionFlag" xlink:type="arc"/>
    <link:presentationArc order="31" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_EntityShellCompany" xlink:type="arc"/>
    <link:presentationArc order="32" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_EntityPublicFloat" xlink:type="arc"/>
    <link:presentationArc order="33" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_EntityCommonStockSharesOutstanding" xlink:type="arc"/>
    <link:presentationArc order="34" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_AuditorFirmId" xlink:type="arc"/>
    <link:presentationArc order="35" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_AuditorName" xlink:type="arc"/>
    <link:presentationArc order="36" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_AuditorLocation" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-consolidated-balance-sheets-parentheticals" xlink:href="hstm-20241231.xsd#statement-consolidated-balance-sheets-parentheticals" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-consolidated-balance-sheets-parentheticals" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_CommonStockNoParValue" xlink:label="us-gaap_CommonStockNoParValue" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_CommonStockSharesAuthorized" xlink:label="us-gaap_CommonStockSharesAuthorized" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_CommonStockSharesIssued" xlink:label="us-gaap_CommonStockSharesIssued" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_CommonStockSharesOutstanding" xlink:label="us-gaap_CommonStockSharesOutstanding" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_PreferredStockParOrStatedValuePerShare" xlink:label="us-gaap_PreferredStockParOrStatedValuePerShare" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_PreferredStockSharesAuthorized" xlink:label="us-gaap_PreferredStockSharesAuthorized" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_PreferredStockSharesIssued" xlink:label="us-gaap_PreferredStockSharesIssued" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_PreferredStockSharesOutstanding" xlink:label="us-gaap_PreferredStockSharesOutstanding" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementOfFinancialPositionAbstract" xlink:label="us-gaap_StatementOfFinancialPositionAbstract" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementOfFinancialPositionAbstract" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_PreferredStockParOrStatedValuePerShare" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_PreferredStockSharesAuthorized" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_PreferredStockSharesIssued" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_PreferredStockSharesOutstanding" xlink:type="arc"/>
    <link:presentationArc order="4" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_CommonStockSharesAuthorized" xlink:type="arc"/>
    <link:presentationArc order="5" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_CommonStockSharesIssued" xlink:type="arc"/>
    <link:presentationArc order="6" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_CommonStockSharesOutstanding" xlink:type="arc"/>
    <link:presentationArc order="7" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_CommonStockNoParValue" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-consolidated-statements-of-shareholders-equity-parentheticals" xlink:href="hstm-20241231.xsd#statement-consolidated-statements-of-shareholders-equity-parentheticals" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-consolidated-statements-of-shareholders-equity-parentheticals" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_CommonStockDividendsPerShareDeclared" xlink:label="us-gaap_CommonStockDividendsPerShareDeclared" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementOfStockholdersEquityAbstract" xlink:label="us-gaap_StatementOfStockholdersEquityAbstract" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementOfStockholdersEquityAbstract" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_CommonStockDividendsPerShareDeclared" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-note-1-summary-of-significant-accounting-policies" xlink:href="hstm-20241231.xsd#statement-note-1-summary-of-significant-accounting-policies" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-note-1-summary-of-significant-accounting-policies" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_NotesToFinancialStatementsAbstract" xlink:label="hstm_NotesToFinancialStatementsAbstract" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/srt/2024/elts/srt-2024.xsd#srt_MaximumMember" xlink:label="srt_MaximumMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/srt/2024/elts/srt-2024.xsd#srt_MinimumMember" xlink:label="srt_MinimumMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/srt/2024/elts/srt-2024.xsd#srt_RangeAxis" xlink:label="srt_RangeAxis" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/srt/2024/elts/srt-2024.xsd#srt_RangeMember" xlink:label="srt_RangeMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/srt/2024/elts/srt-2024.xsd#srt_WeightedAverageMember" xlink:label="srt_WeightedAverageMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_BusinessDescriptionAndAccountingPoliciesTextBlock" xlink:label="us-gaap_BusinessDescriptionAndAccountingPoliciesTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DisclosureTextBlockAbstract" xlink:label="us-gaap_DisclosureTextBlockAbstract" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DisclosureTextBlockAbstract" xlink:label="us-gaap_DisclosureTextBlockAbstract-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_IncomeStatementLocationAxis" xlink:label="us-gaap_IncomeStatementLocationAxis" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_IncomeStatementLocationDomain" xlink:label="us-gaap_IncomeStatementLocationDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_SellingAndMarketingExpenseMember" xlink:label="us-gaap_SellingAndMarketingExpenseMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_NotesToFinancialStatementsAbstract" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_DisclosureTextBlockAbstract-2" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeAxis" xlink:to="srt_RangeMember" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeStatementLocationAxis" xlink:to="us-gaap_IncomeStatementLocationDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="srt_RangeAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeAxis" xlink:to="srt_MinimumMember" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeAxis" xlink:to="srt_MaximumMember" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeAxis" xlink:to="srt_WeightedAverageMember" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_IncomeStatementLocationAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeStatementLocationAxis" xlink:to="us-gaap_SellingAndMarketingExpenseMember" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DisclosureTextBlockAbstract" xlink:to="us-gaap_BusinessDescriptionAndAccountingPoliciesTextBlock" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-note-2-shareholders-equity" xlink:href="hstm-20241231.xsd#statement-note-2-shareholders-equity" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-note-2-shareholders-equity" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_March2022ShareRepurchaseProgramMember" xlink:label="hstm_March2022ShareRepurchaseProgramMember" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_NotesToFinancialStatementsAbstract" xlink:label="hstm_NotesToFinancialStatementsAbstract" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_November2021ShareRepurchaseProgramMember" xlink:label="hstm_November2021ShareRepurchaseProgramMember" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_O2025Q1DividendsMember" xlink:label="hstm_O2025Q1DividendsMember" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_September2023ShareRepurchaseProgramMember" xlink:label="hstm_September2023ShareRepurchaseProgramMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/srt/2024/elts/srt-2024.xsd#srt_ShareRepurchaseProgramAxis" xlink:label="srt_ShareRepurchaseProgramAxis" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/srt/2024/elts/srt-2024.xsd#srt_ShareRepurchaseProgramDomain" xlink:label="srt_ShareRepurchaseProgramDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DisclosureTextBlockAbstract" xlink:label="us-gaap_DisclosureTextBlockAbstract" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DisclosureTextBlockAbstract" xlink:label="us-gaap_DisclosureTextBlockAbstract-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DividendsAxis" xlink:label="us-gaap_DividendsAxis" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DividendsDomain" xlink:label="us-gaap_DividendsDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StockholdersEquityNoteDisclosureTextBlock" xlink:label="us-gaap_StockholdersEquityNoteDisclosureTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_SubsequentEventMember" xlink:label="us-gaap_SubsequentEventMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_SubsequentEventTypeAxis" xlink:label="us-gaap_SubsequentEventTypeAxis" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_SubsequentEventTypeDomain" xlink:label="us-gaap_SubsequentEventTypeDomain" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_NotesToFinancialStatementsAbstract" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_DisclosureTextBlockAbstract-2" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DividendsAxis" xlink:to="us-gaap_DividendsDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_SubsequentEventTypeAxis" xlink:to="us-gaap_SubsequentEventTypeDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ShareRepurchaseProgramAxis" xlink:to="srt_ShareRepurchaseProgramDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_SubsequentEventTypeAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_SubsequentEventTypeAxis" xlink:to="us-gaap_SubsequentEventMember" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_DividendsAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DividendsAxis" xlink:to="hstm_O2025Q1DividendsMember" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="srt_ShareRepurchaseProgramAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ShareRepurchaseProgramAxis" xlink:to="hstm_November2021ShareRepurchaseProgramMember" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ShareRepurchaseProgramAxis" xlink:to="hstm_March2022ShareRepurchaseProgramMember" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ShareRepurchaseProgramAxis" xlink:to="hstm_September2023ShareRepurchaseProgramMember" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="4" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DisclosureTextBlockAbstract" xlink:to="us-gaap_StockholdersEquityNoteDisclosureTextBlock" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-note-3-net-income-per-share" xlink:href="hstm-20241231.xsd#statement-note-3-net-income-per-share" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-note-3-net-income-per-share" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_NotesToFinancialStatementsAbstract" xlink:label="hstm_NotesToFinancialStatementsAbstract" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DisclosureTextBlockAbstract" xlink:label="us-gaap_DisclosureTextBlockAbstract" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DisclosureTextBlockAbstract" xlink:label="us-gaap_DisclosureTextBlockAbstract-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_EarningsPerShareTextBlock" xlink:label="us-gaap_EarningsPerShareTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_NotesToFinancialStatementsAbstract" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_DisclosureTextBlockAbstract-2" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DisclosureTextBlockAbstract" xlink:to="us-gaap_EarningsPerShareTextBlock" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-note-5-revenue-recognition" xlink:href="hstm-20241231.xsd#statement-note-5-revenue-recognition" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-note-5-revenue-recognition" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_NotesToFinancialStatementsAbstract" xlink:label="hstm_NotesToFinancialStatementsAbstract" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DisclosureTextBlockAbstract" xlink:label="us-gaap_DisclosureTextBlockAbstract" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DisclosureTextBlockAbstract" xlink:label="us-gaap_DisclosureTextBlockAbstract-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_RevenueFromContractWithCustomerTextBlock" xlink:label="us-gaap_RevenueFromContractWithCustomerTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_NotesToFinancialStatementsAbstract" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_DisclosureTextBlockAbstract-2" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DisclosureTextBlockAbstract" xlink:to="us-gaap_RevenueFromContractWithCustomerTextBlock" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-note-6-property-and-equipment-" xlink:href="hstm-20241231.xsd#statement-note-6-property-and-equipment-" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-note-6-property-and-equipment-" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_NotesToFinancialStatementsAbstract" xlink:label="hstm_NotesToFinancialStatementsAbstract" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DisclosureTextBlockAbstract" xlink:label="us-gaap_DisclosureTextBlockAbstract" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DisclosureTextBlockAbstract" xlink:label="us-gaap_DisclosureTextBlockAbstract-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_PropertyPlantAndEquipmentDisclosureTextBlock" xlink:label="us-gaap_PropertyPlantAndEquipmentDisclosureTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_NotesToFinancialStatementsAbstract" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_DisclosureTextBlockAbstract-2" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DisclosureTextBlockAbstract" xlink:to="us-gaap_PropertyPlantAndEquipmentDisclosureTextBlock" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-note-7-goodwill-and-intangible-assets" xlink:href="hstm-20241231.xsd#statement-note-7-goodwill-and-intangible-assets" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-note-7-goodwill-and-intangible-assets" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_NotesToFinancialStatementsAbstract" xlink:label="hstm_NotesToFinancialStatementsAbstract" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/srt/2024/elts/srt-2024.xsd#srt_MaximumMember" xlink:label="srt_MaximumMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/srt/2024/elts/srt-2024.xsd#srt_MinimumMember" xlink:label="srt_MinimumMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/srt/2024/elts/srt-2024.xsd#srt_RangeAxis" xlink:label="srt_RangeAxis" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/srt/2024/elts/srt-2024.xsd#srt_RangeMember" xlink:label="srt_RangeMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_CustomerRelationshipsMember" xlink:label="us-gaap_CustomerRelationshipsMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DisclosureTextBlockAbstract" xlink:label="us-gaap_DisclosureTextBlockAbstract" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DisclosureTextBlockAbstract" xlink:label="us-gaap_DisclosureTextBlockAbstract-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis" xlink:label="us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain" xlink:label="us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_GoodwillAndIntangibleAssetsDisclosureTextBlock" xlink:label="us-gaap_GoodwillAndIntangibleAssetsDisclosureTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_OtherIntangibleAssetsMember" xlink:label="us-gaap_OtherIntangibleAssetsMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_NotesToFinancialStatementsAbstract" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_DisclosureTextBlockAbstract-2" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeAxis" xlink:to="srt_RangeMember" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis" xlink:to="us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="srt_RangeAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeAxis" xlink:to="srt_MinimumMember" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis" xlink:to="us-gaap_CustomerRelationshipsMember" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeAxis" xlink:to="srt_MaximumMember" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis" xlink:to="us-gaap_OtherIntangibleAssetsMember" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DisclosureTextBlockAbstract" xlink:to="us-gaap_GoodwillAndIntangibleAssetsDisclosureTextBlock" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-note-8-business-combinations" xlink:href="hstm-20241231.xsd#statement-note-8-business-combinations" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-note-8-business-combinations" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_CloudCMELLCMember" xlink:label="hstm_CloudCMELLCMember" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_ElectronicEducationDocumentationSystemLlcMember" xlink:label="hstm_ElectronicEducationDocumentationSystemLlcMember" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_NotesToFinancialStatementsAbstract" xlink:label="hstm_NotesToFinancialStatementsAbstract" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_TotalClinicalPlacementSystemAndTheClinicalHubMember" xlink:label="hstm_TotalClinicalPlacementSystemAndTheClinicalHubMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_BusinessAcquisitionAcquireeDomain" xlink:label="us-gaap_BusinessAcquisitionAcquireeDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_BusinessAcquisitionAxis" xlink:label="us-gaap_BusinessAcquisitionAxis" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_BusinessCombinationDisclosureTextBlock" xlink:label="us-gaap_BusinessCombinationDisclosureTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DisclosureTextBlockAbstract" xlink:label="us-gaap_DisclosureTextBlockAbstract" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DisclosureTextBlockAbstract" xlink:label="us-gaap_DisclosureTextBlockAbstract-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_NotesToFinancialStatementsAbstract" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_DisclosureTextBlockAbstract-2" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionAxis" xlink:to="us-gaap_BusinessAcquisitionAcquireeDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_BusinessAcquisitionAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionAxis" xlink:to="hstm_TotalClinicalPlacementSystemAndTheClinicalHubMember" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionAxis" xlink:to="hstm_ElectronicEducationDocumentationSystemLlcMember" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionAxis" xlink:to="hstm_CloudCMELLCMember" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DisclosureTextBlockAbstract" xlink:to="us-gaap_BusinessCombinationDisclosureTextBlock" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-note-9-income-taxes" xlink:href="hstm-20241231.xsd#statement-note-9-income-taxes" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-note-9-income-taxes" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_NotesToFinancialStatementsAbstract" xlink:label="hstm_NotesToFinancialStatementsAbstract" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DisclosureTextBlockAbstract" xlink:label="us-gaap_DisclosureTextBlockAbstract" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DisclosureTextBlockAbstract" xlink:label="us-gaap_DisclosureTextBlockAbstract-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DomesticCountryMember" xlink:label="us-gaap_DomesticCountryMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ForeignCountryMember" xlink:label="us-gaap_ForeignCountryMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_IncomeTaxAuthorityAxis" xlink:label="us-gaap_IncomeTaxAuthorityAxis" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_IncomeTaxAuthorityDomain" xlink:label="us-gaap_IncomeTaxAuthorityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_IncomeTaxDisclosureTextBlock" xlink:label="us-gaap_IncomeTaxDisclosureTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StateAndLocalJurisdictionMember" xlink:label="us-gaap_StateAndLocalJurisdictionMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_NotesToFinancialStatementsAbstract" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_DisclosureTextBlockAbstract-2" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxAuthorityAxis" xlink:to="us-gaap_IncomeTaxAuthorityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_IncomeTaxAuthorityAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxAuthorityAxis" xlink:to="us-gaap_DomesticCountryMember" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxAuthorityAxis" xlink:to="us-gaap_StateAndLocalJurisdictionMember" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxAuthorityAxis" xlink:to="us-gaap_ForeignCountryMember" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DisclosureTextBlockAbstract" xlink:to="us-gaap_IncomeTaxDisclosureTextBlock" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-note-10-stockbased-compensation-" xlink:href="hstm-20241231.xsd#statement-note-10-stockbased-compensation-" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-note-10-stockbased-compensation-" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_NotesToFinancialStatementsAbstract" xlink:label="hstm_NotesToFinancialStatementsAbstract" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_StockOptionsAndRestrictedStockUnitsMember" xlink:label="hstm_StockOptionsAndRestrictedStockUnitsMember" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_The2016PlanMember" xlink:label="hstm_The2016PlanMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_AwardTypeAxis" xlink:label="us-gaap_AwardTypeAxis" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlock" xlink:label="us-gaap_DisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DisclosureTextBlockAbstract" xlink:label="us-gaap_DisclosureTextBlockAbstract" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DisclosureTextBlockAbstract" xlink:label="us-gaap_DisclosureTextBlockAbstract-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_PlanNameAxis" xlink:label="us-gaap_PlanNameAxis" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_PlanNameDomain" xlink:label="us-gaap_PlanNameDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_RestrictedStockMember" xlink:label="us-gaap_RestrictedStockMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:label="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_NotesToFinancialStatementsAbstract" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_DisclosureTextBlockAbstract-2" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AwardTypeAxis" xlink:to="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PlanNameAxis" xlink:to="us-gaap_PlanNameDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_PlanNameAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PlanNameAxis" xlink:to="hstm_The2016PlanMember" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_AwardTypeAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AwardTypeAxis" xlink:to="us-gaap_RestrictedStockMember" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AwardTypeAxis" xlink:to="hstm_StockOptionsAndRestrictedStockUnitsMember" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DisclosureTextBlockAbstract" xlink:to="us-gaap_DisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlock" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-note-11-employee-benefit-plan-" xlink:href="hstm-20241231.xsd#statement-note-11-employee-benefit-plan-" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-note-11-employee-benefit-plan-" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_NotesToFinancialStatementsAbstract" xlink:label="hstm_NotesToFinancialStatementsAbstract" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DisclosureTextBlockAbstract" xlink:label="us-gaap_DisclosureTextBlockAbstract" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DisclosureTextBlockAbstract" xlink:label="us-gaap_DisclosureTextBlockAbstract-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_PensionAndOtherPostretirementBenefitsDisclosureTextBlock" xlink:label="us-gaap_PensionAndOtherPostretirementBenefitsDisclosureTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_NotesToFinancialStatementsAbstract" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_DisclosureTextBlockAbstract-2" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DisclosureTextBlockAbstract" xlink:to="us-gaap_PensionAndOtherPostretirementBenefitsDisclosureTextBlock" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-note-12-debt" xlink:href="hstm-20241231.xsd#statement-note-12-debt" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-note-12-debt" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_LetterOfCreditSubfacilityMember" xlink:label="hstm_LetterOfCreditSubfacilityMember" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_NotesToFinancialStatementsAbstract" xlink:label="hstm_NotesToFinancialStatementsAbstract" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_SwingLineSubfacilityMember" xlink:label="hstm_SwingLineSubfacilityMember" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_ThirdAmendmentMember" xlink:label="hstm_ThirdAmendmentMember" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_TruistBankMember" xlink:label="hstm_TruistBankMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/srt/2024/elts/srt-2024.xsd#srt_MaximumMember" xlink:label="srt_MaximumMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/srt/2024/elts/srt-2024.xsd#srt_MinimumMember" xlink:label="srt_MinimumMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/srt/2024/elts/srt-2024.xsd#srt_RangeAxis" xlink:label="srt_RangeAxis" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/srt/2024/elts/srt-2024.xsd#srt_RangeMember" xlink:label="srt_RangeMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_BaseRateMember" xlink:label="us-gaap_BaseRateMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_CreditFacilityAxis" xlink:label="us-gaap_CreditFacilityAxis" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_CreditFacilityDomain" xlink:label="us-gaap_CreditFacilityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DebtDisclosureTextBlock" xlink:label="us-gaap_DebtDisclosureTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DisclosureTextBlockAbstract" xlink:label="us-gaap_DisclosureTextBlockAbstract" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DisclosureTextBlockAbstract" xlink:label="us-gaap_DisclosureTextBlockAbstract-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_FederalFundsEffectiveSwapRateMember" xlink:label="us-gaap_FederalFundsEffectiveSwapRateMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_LineOfCreditFacilityAxis" xlink:label="us-gaap_LineOfCreditFacilityAxis" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_LineOfCreditFacilityLenderDomain" xlink:label="us-gaap_LineOfCreditFacilityLenderDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_LongtermDebtTypeAxis" xlink:label="us-gaap_LongtermDebtTypeAxis" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_LongtermDebtTypeDomain" xlink:label="us-gaap_LongtermDebtTypeDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_RevolvingCreditFacilityMember" xlink:label="us-gaap_RevolvingCreditFacilityMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_SecuredOvernightFinancingRateSofrOvernightIndexSwapRateMember" xlink:label="us-gaap_SecuredOvernightFinancingRateSofrOvernightIndexSwapRateMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ShortTermDebtTypeAxis" xlink:label="us-gaap_ShortTermDebtTypeAxis" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ShortTermDebtTypeDomain" xlink:label="us-gaap_ShortTermDebtTypeDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_VariableRateAxis" xlink:label="us-gaap_VariableRateAxis" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_VariableRateDomain" xlink:label="us-gaap_VariableRateDomain" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_NotesToFinancialStatementsAbstract" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_DisclosureTextBlockAbstract-2" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeAxis" xlink:to="srt_RangeMember" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShortTermDebtTypeAxis" xlink:to="us-gaap_ShortTermDebtTypeDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CreditFacilityAxis" xlink:to="us-gaap_CreditFacilityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LongtermDebtTypeAxis" xlink:to="us-gaap_LongtermDebtTypeDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_VariableRateAxis" xlink:to="us-gaap_VariableRateDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LineOfCreditFacilityAxis" xlink:to="us-gaap_LineOfCreditFacilityLenderDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_LongtermDebtTypeAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LongtermDebtTypeAxis" xlink:to="hstm_ThirdAmendmentMember" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_CreditFacilityAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CreditFacilityAxis" xlink:to="us-gaap_RevolvingCreditFacilityMember" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_LineOfCreditFacilityAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LineOfCreditFacilityAxis" xlink:to="hstm_TruistBankMember" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_ShortTermDebtTypeAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShortTermDebtTypeAxis" xlink:to="hstm_SwingLineSubfacilityMember" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShortTermDebtTypeAxis" xlink:to="hstm_LetterOfCreditSubfacilityMember" xlink:type="arc"/>
    <link:presentationArc order="4" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_VariableRateAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_VariableRateAxis" xlink:to="us-gaap_FederalFundsEffectiveSwapRateMember" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_VariableRateAxis" xlink:to="us-gaap_BaseRateMember" xlink:type="arc"/>
    <link:presentationArc order="5" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="srt_RangeAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeAxis" xlink:to="srt_MinimumMember" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_VariableRateAxis" xlink:to="us-gaap_SecuredOvernightFinancingRateSofrOvernightIndexSwapRateMember" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeAxis" xlink:to="srt_MaximumMember" xlink:type="arc"/>
    <link:presentationArc order="6" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="7" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DisclosureTextBlockAbstract" xlink:to="us-gaap_DebtDisclosureTextBlock" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-note-13-leases-" xlink:href="hstm-20241231.xsd#statement-note-13-leases-" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-note-13-leases-" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_NotesToFinancialStatementsAbstract" xlink:label="hstm_NotesToFinancialStatementsAbstract" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DisclosureTextBlockAbstract" xlink:label="us-gaap_DisclosureTextBlockAbstract" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DisclosureTextBlockAbstract" xlink:label="us-gaap_DisclosureTextBlockAbstract-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_LesseeOperatingLeasesTextBlock" xlink:label="us-gaap_LesseeOperatingLeasesTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_NotesToFinancialStatementsAbstract" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_DisclosureTextBlockAbstract-2" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DisclosureTextBlockAbstract" xlink:to="us-gaap_LesseeOperatingLeasesTextBlock" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://xbrl.sec.gov/ecd/role/InsiderTradingArrangements" xlink:href="https://xbrl.sec.gov/ecd/2024/ecd-2024.xsd#InsiderTradingArrangements" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://xbrl.sec.gov/ecd/role/InsiderTradingArrangements" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/ecd/2024/ecd-2024.xsd#ecd_InsiderTradingArrLineItems" xlink:label="ecd_InsiderTradingArrLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/ecd/2024/ecd-2024.xsd#ecd_MtrlTermsOfTrdArrTextBlock" xlink:label="ecd_MtrlTermsOfTrdArrTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/ecd/2024/ecd-2024.xsd#ecd_NonRule10b51ArrAdoptedFlag" xlink:label="ecd_NonRule10b51ArrAdoptedFlag-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/ecd/2024/ecd-2024.xsd#ecd_NonRule10b51ArrTrmntdFlag" xlink:label="ecd_NonRule10b51ArrTrmntdFlag-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/ecd/2024/ecd-2024.xsd#ecd_Rule10b51ArrAdoptedFlag" xlink:label="ecd_Rule10b51ArrAdoptedFlag-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/ecd/2024/ecd-2024.xsd#ecd_Rule10b51ArrTrmntdFlag" xlink:label="ecd_Rule10b51ArrTrmntdFlag-2" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="ecd_InsiderTradingArrLineItems" xlink:to="ecd_MtrlTermsOfTrdArrTextBlock" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="ecd_InsiderTradingArrLineItems" xlink:to="ecd_Rule10b51ArrAdoptedFlag-2" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="ecd_InsiderTradingArrLineItems" xlink:to="ecd_NonRule10b51ArrAdoptedFlag-2" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="ecd_InsiderTradingArrLineItems" xlink:to="ecd_Rule10b51ArrTrmntdFlag-2" xlink:type="arc"/>
    <link:presentationArc order="4" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="ecd_InsiderTradingArrLineItems" xlink:to="ecd_NonRule10b51ArrTrmntdFlag-2" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-significant-accounting-policies-policies" xlink:href="hstm-20241231.xsd#statement-significant-accounting-policies-policies" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-significant-accounting-policies-policies" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_RevenueFromContractWithCustomerCommissionsPolicyPolicyTextBlock" xlink:label="hstm_RevenueFromContractWithCustomerCommissionsPolicyPolicyTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_statement-statement-significant-accounting-policies-policies" xlink:label="hstm_statement-statement-significant-accounting-policies-policies" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_AccountingPoliciesAbstract" xlink:label="us-gaap_AccountingPoliciesAbstract" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_AdvertisingCostsPolicyTextBlock" xlink:label="us-gaap_AdvertisingCostsPolicyTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_BasisOfAccountingPolicyPolicyTextBlock" xlink:label="us-gaap_BasisOfAccountingPolicyPolicyTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_CashAndCashEquivalentsPolicyTextBlock" xlink:label="us-gaap_CashAndCashEquivalentsPolicyTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ConcentrationRiskCreditRisk" xlink:label="us-gaap_ConcentrationRiskCreditRisk" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_CreditLossFinancialInstrumentPolicyTextBlock" xlink:label="us-gaap_CreditLossFinancialInstrumentPolicyTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DeferredChargesPolicyTextBlock" xlink:label="us-gaap_DeferredChargesPolicyTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_EarningsPerSharePolicyTextBlock" xlink:label="us-gaap_EarningsPerSharePolicyTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_EquitySecuritiesWithoutReadilyDeterminableFairValuePolicyTextBlock" xlink:label="us-gaap_EquitySecuritiesWithoutReadilyDeterminableFairValuePolicyTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_FairValueMeasurementPolicyPolicyTextBlock" xlink:label="us-gaap_FairValueMeasurementPolicyPolicyTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_FairValueOfFinancialInstrumentsPolicy" xlink:label="us-gaap_FairValueOfFinancialInstrumentsPolicy" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ForeignCurrencyTransactionsAndTranslationsPolicyTextBlock" xlink:label="us-gaap_ForeignCurrencyTransactionsAndTranslationsPolicyTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_GoodwillAndIntangibleAssetsGoodwillPolicy" xlink:label="us-gaap_GoodwillAndIntangibleAssetsGoodwillPolicy" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_GoodwillAndIntangibleAssetsIntangibleAssetsPolicy" xlink:label="us-gaap_GoodwillAndIntangibleAssetsIntangibleAssetsPolicy" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ImpairmentOrDisposalOfLongLivedAssetsPolicyTextBlock" xlink:label="us-gaap_ImpairmentOrDisposalOfLongLivedAssetsPolicyTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_IncomeTaxPolicyTextBlock" xlink:label="us-gaap_IncomeTaxPolicyTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_LesseeLeasesPolicyTextBlock" xlink:label="us-gaap_LesseeLeasesPolicyTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_MarketableSecuritiesPolicy" xlink:label="us-gaap_MarketableSecuritiesPolicy" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_NewAccountingPronouncementsPolicyPolicyTextBlock" xlink:label="us-gaap_NewAccountingPronouncementsPolicyPolicyTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_PolicyTextBlockAbstract" xlink:label="us-gaap_PolicyTextBlockAbstract" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_PolicyTextBlockAbstract" xlink:label="us-gaap_PolicyTextBlockAbstract-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_PriorPeriodReclassificationAdjustmentDescription" xlink:label="us-gaap_PriorPeriodReclassificationAdjustmentDescription" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_PropertyPlantAndEquipmentPolicyTextBlock" xlink:label="us-gaap_PropertyPlantAndEquipmentPolicyTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ResearchDevelopmentAndComputerSoftwarePolicyTextBlock" xlink:label="us-gaap_ResearchDevelopmentAndComputerSoftwarePolicyTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_RevenueFromContractWithCustomerPolicyTextBlock" xlink:label="us-gaap_RevenueFromContractWithCustomerPolicyTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_SegmentReportingPolicyPolicyTextBlock" xlink:label="us-gaap_SegmentReportingPolicyPolicyTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ShareBasedCompensationOptionAndIncentivePlansPolicy" xlink:label="us-gaap_ShareBasedCompensationOptionAndIncentivePlansPolicy" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_UseOfEstimates" xlink:label="us-gaap_UseOfEstimates" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_statement-statement-significant-accounting-policies-policies" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_PolicyTextBlockAbstract-2" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PolicyTextBlockAbstract" xlink:to="us-gaap_AccountingPoliciesAbstract" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_RevenueFromContractWithCustomerPolicyTextBlock" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_BasisOfAccountingPolicyPolicyTextBlock" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_SegmentReportingPolicyPolicyTextBlock" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_UseOfEstimates" xlink:type="arc"/>
    <link:presentationArc order="4" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_CashAndCashEquivalentsPolicyTextBlock" xlink:type="arc"/>
    <link:presentationArc order="5" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_MarketableSecuritiesPolicy" xlink:type="arc"/>
    <link:presentationArc order="6" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="hstm_RevenueFromContractWithCustomerCommissionsPolicyPolicyTextBlock" xlink:type="arc"/>
    <link:presentationArc order="7" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_DeferredChargesPolicyTextBlock" xlink:type="arc"/>
    <link:presentationArc order="8" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_CreditLossFinancialInstrumentPolicyTextBlock" xlink:type="arc"/>
    <link:presentationArc order="9" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_ResearchDevelopmentAndComputerSoftwarePolicyTextBlock" xlink:type="arc"/>
    <link:presentationArc order="10" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_FairValueMeasurementPolicyPolicyTextBlock" xlink:type="arc"/>
    <link:presentationArc order="11" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_PropertyPlantAndEquipmentPolicyTextBlock" xlink:type="arc"/>
    <link:presentationArc order="12" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_GoodwillAndIntangibleAssetsGoodwillPolicy" xlink:type="arc"/>
    <link:presentationArc order="13" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_GoodwillAndIntangibleAssetsIntangibleAssetsPolicy" xlink:type="arc"/>
    <link:presentationArc order="14" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_ImpairmentOrDisposalOfLongLivedAssetsPolicyTextBlock" xlink:type="arc"/>
    <link:presentationArc order="15" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_EquitySecuritiesWithoutReadilyDeterminableFairValuePolicyTextBlock" xlink:type="arc"/>
    <link:presentationArc order="16" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_FairValueOfFinancialInstrumentsPolicy" xlink:type="arc"/>
    <link:presentationArc order="17" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_AdvertisingCostsPolicyTextBlock" xlink:type="arc"/>
    <link:presentationArc order="18" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_IncomeTaxPolicyTextBlock" xlink:type="arc"/>
    <link:presentationArc order="19" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_EarningsPerSharePolicyTextBlock" xlink:type="arc"/>
    <link:presentationArc order="20" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_ConcentrationRiskCreditRisk" xlink:type="arc"/>
    <link:presentationArc order="21" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_ShareBasedCompensationOptionAndIncentivePlansPolicy" xlink:type="arc"/>
    <link:presentationArc order="22" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_LesseeLeasesPolicyTextBlock" xlink:type="arc"/>
    <link:presentationArc order="23" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_ForeignCurrencyTransactionsAndTranslationsPolicyTextBlock" xlink:type="arc"/>
    <link:presentationArc order="24" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_PriorPeriodReclassificationAdjustmentDescription" xlink:type="arc"/>
    <link:presentationArc order="25" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_NewAccountingPronouncementsPolicyPolicyTextBlock" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-note-1-summary-of-significant-accounting-policies-tables" xlink:href="hstm-20241231.xsd#statement-note-1-summary-of-significant-accounting-policies-tables" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-note-1-summary-of-significant-accounting-policies-tables" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_PropertyPlantAndEquipmentUsefulLivesTableTextBlock" xlink:label="hstm_PropertyPlantAndEquipmentUsefulLivesTableTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_statement-statement-note-1-summary-of-significant-accounting-policies-tables" xlink:label="hstm_statement-statement-note-1-summary-of-significant-accounting-policies-tables" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_AllowanceForCreditLossesOnFinancingReceivablesTableTextBlock" xlink:label="us-gaap_AllowanceForCreditLossesOnFinancingReceivablesTableTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_TableTextBlock" xlink:label="us-gaap_TableTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_TableTextBlock" xlink:label="us-gaap_TableTextBlock-2" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_statement-statement-note-1-summary-of-significant-accounting-policies-tables" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_TableTextBlock-2" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_TableTextBlock" xlink:to="us-gaap_AllowanceForCreditLossesOnFinancingReceivablesTableTextBlock" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_TableTextBlock" xlink:to="hstm_PropertyPlantAndEquipmentUsefulLivesTableTextBlock" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-note-3-net-income-per-share-tables" xlink:href="hstm-20241231.xsd#statement-note-3-net-income-per-share-tables" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-note-3-net-income-per-share-tables" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_statement-statement-note-3-net-income-per-share-tables" xlink:label="hstm_statement-statement-note-3-net-income-per-share-tables" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ScheduleOfEarningsPerShareBasicAndDilutedTableTextBlock" xlink:label="us-gaap_ScheduleOfEarningsPerShareBasicAndDilutedTableTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_TableTextBlock" xlink:label="us-gaap_TableTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_TableTextBlock" xlink:label="us-gaap_TableTextBlock-2" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_statement-statement-note-3-net-income-per-share-tables" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_TableTextBlock-2" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_TableTextBlock" xlink:to="us-gaap_ScheduleOfEarningsPerShareBasicAndDilutedTableTextBlock" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-note-4-marketable-securities-tables" xlink:href="hstm-20241231.xsd#statement-note-4-marketable-securities-tables" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-note-4-marketable-securities-tables" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_statement-statement-note-4-marketable-securities-tables" xlink:label="hstm_statement-statement-note-4-marketable-securities-tables" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DebtSecuritiesAvailableForSaleTableTextBlock" xlink:label="us-gaap_DebtSecuritiesAvailableForSaleTableTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_TableTextBlock" xlink:label="us-gaap_TableTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_TableTextBlock" xlink:label="us-gaap_TableTextBlock-2" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_statement-statement-note-4-marketable-securities-tables" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_TableTextBlock-2" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_TableTextBlock" xlink:to="us-gaap_DebtSecuritiesAvailableForSaleTableTextBlock" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-note-5-revenue-recognition-tables" xlink:href="hstm-20241231.xsd#statement-note-5-revenue-recognition-tables" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-note-5-revenue-recognition-tables" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_statement-statement-note-5-revenue-recognition-tables" xlink:label="hstm_statement-statement-note-5-revenue-recognition-tables" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DisaggregationOfRevenueTableTextBlock" xlink:label="us-gaap_DisaggregationOfRevenueTableTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_TableTextBlock" xlink:label="us-gaap_TableTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_TableTextBlock" xlink:label="us-gaap_TableTextBlock-2" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_statement-statement-note-5-revenue-recognition-tables" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_TableTextBlock-2" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_TableTextBlock" xlink:to="us-gaap_DisaggregationOfRevenueTableTextBlock" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-note-6-property-and-equipment-tables" xlink:href="hstm-20241231.xsd#statement-note-6-property-and-equipment-tables" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-note-6-property-and-equipment-tables" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_statement-statement-note-6-property-and-equipment-tables" xlink:label="hstm_statement-statement-note-6-property-and-equipment-tables" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_PropertyPlantAndEquipmentTextBlock" xlink:label="us-gaap_PropertyPlantAndEquipmentTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_TableTextBlock" xlink:label="us-gaap_TableTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_TableTextBlock" xlink:label="us-gaap_TableTextBlock-2" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_statement-statement-note-6-property-and-equipment-tables" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_TableTextBlock-2" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_TableTextBlock" xlink:to="us-gaap_PropertyPlantAndEquipmentTextBlock" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-note-7-goodwill-and-intangible-assets-tables" xlink:href="hstm-20241231.xsd#statement-note-7-goodwill-and-intangible-assets-tables" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-note-7-goodwill-and-intangible-assets-tables" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_statement-statement-note-7-goodwill-and-intangible-assets-tables" xlink:label="hstm_statement-statement-note-7-goodwill-and-intangible-assets-tables" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTableTextBlock" xlink:label="us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTableTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ScheduleOfGoodwillTextBlock" xlink:label="us-gaap_ScheduleOfGoodwillTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ScheduleofFiniteLivedIntangibleAssetsFutureAmortizationExpenseTableTextBlock" xlink:label="us-gaap_ScheduleofFiniteLivedIntangibleAssetsFutureAmortizationExpenseTableTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_TableTextBlock" xlink:label="us-gaap_TableTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_TableTextBlock" xlink:label="us-gaap_TableTextBlock-2" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_statement-statement-note-7-goodwill-and-intangible-assets-tables" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_TableTextBlock-2" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_TableTextBlock" xlink:to="us-gaap_ScheduleOfGoodwillTextBlock" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_TableTextBlock" xlink:to="us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTableTextBlock" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_TableTextBlock" xlink:to="us-gaap_ScheduleofFiniteLivedIntangibleAssetsFutureAmortizationExpenseTableTextBlock" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-note-9-income-taxes-tables" xlink:href="hstm-20241231.xsd#statement-note-9-income-taxes-tables" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-note-9-income-taxes-tables" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_statement-statement-note-9-income-taxes-tables" xlink:label="hstm_statement-statement-note-9-income-taxes-tables" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ScheduleOfComponentsOfIncomeTaxExpenseBenefitTableTextBlock" xlink:label="us-gaap_ScheduleOfComponentsOfIncomeTaxExpenseBenefitTableTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ScheduleOfDeferredTaxAssetsAndLiabilitiesTableTextBlock" xlink:label="us-gaap_ScheduleOfDeferredTaxAssetsAndLiabilitiesTableTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ScheduleOfEffectiveIncomeTaxRateReconciliationTableTextBlock" xlink:label="us-gaap_ScheduleOfEffectiveIncomeTaxRateReconciliationTableTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ScheduleOfIncomeBeforeIncomeTaxDomesticAndForeignTableTextBlock" xlink:label="us-gaap_ScheduleOfIncomeBeforeIncomeTaxDomesticAndForeignTableTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ScheduleOfUnrecognizedTaxBenefitsRollForwardTableTextBlock" xlink:label="us-gaap_ScheduleOfUnrecognizedTaxBenefitsRollForwardTableTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_TableTextBlock" xlink:label="us-gaap_TableTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_TableTextBlock" xlink:label="us-gaap_TableTextBlock-2" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_statement-statement-note-9-income-taxes-tables" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_TableTextBlock-2" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_TableTextBlock" xlink:to="us-gaap_ScheduleOfIncomeBeforeIncomeTaxDomesticAndForeignTableTextBlock" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_TableTextBlock" xlink:to="us-gaap_ScheduleOfComponentsOfIncomeTaxExpenseBenefitTableTextBlock" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_TableTextBlock" xlink:to="us-gaap_ScheduleOfEffectiveIncomeTaxRateReconciliationTableTextBlock" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_TableTextBlock" xlink:to="us-gaap_ScheduleOfUnrecognizedTaxBenefitsRollForwardTableTextBlock" xlink:type="arc"/>
    <link:presentationArc order="4" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_TableTextBlock" xlink:to="us-gaap_ScheduleOfDeferredTaxAssetsAndLiabilitiesTableTextBlock" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-note-10-stockbased-compensation-tables" xlink:href="hstm-20241231.xsd#statement-note-10-stockbased-compensation-tables" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-note-10-stockbased-compensation-tables" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_statement-statement-note-10-stockbased-compensation-tables" xlink:label="hstm_statement-statement-note-10-stockbased-compensation-tables" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ScheduleOfEmployeeServiceShareBasedCompensationAllocationOfRecognizedPeriodCostsTextBlock" xlink:label="us-gaap_ScheduleOfEmployeeServiceShareBasedCompensationAllocationOfRecognizedPeriodCostsTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ScheduleOfShareBasedCompensationRestrictedStockUnitsAwardActivityTableTextBlock" xlink:label="us-gaap_ScheduleOfShareBasedCompensationRestrictedStockUnitsAwardActivityTableTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ScheduleOfShareBasedCompensationStockOptionsActivityTableTextBlock" xlink:label="us-gaap_ScheduleOfShareBasedCompensationStockOptionsActivityTableTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_TableTextBlock" xlink:label="us-gaap_TableTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_TableTextBlock" xlink:label="us-gaap_TableTextBlock-2" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_statement-statement-note-10-stockbased-compensation-tables" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_TableTextBlock-2" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_TableTextBlock" xlink:to="us-gaap_ScheduleOfShareBasedCompensationStockOptionsActivityTableTextBlock" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_TableTextBlock" xlink:to="us-gaap_ScheduleOfShareBasedCompensationRestrictedStockUnitsAwardActivityTableTextBlock" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_TableTextBlock" xlink:to="us-gaap_ScheduleOfEmployeeServiceShareBasedCompensationAllocationOfRecognizedPeriodCostsTextBlock" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-note-13-leases-tables" xlink:href="hstm-20241231.xsd#statement-note-13-leases-tables" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-note-13-leases-tables" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_LesseeOperatingLeaseAssetsAndLiabilitiesTableTextBlock" xlink:label="hstm_LesseeOperatingLeaseAssetsAndLiabilitiesTableTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_statement-statement-note-13-leases-tables" xlink:label="hstm_statement-statement-note-13-leases-tables" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_LesseeOperatingLeaseLiabilityMaturityTableTextBlock" xlink:label="us-gaap_LesseeOperatingLeaseLiabilityMaturityTableTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_TableTextBlock" xlink:label="us-gaap_TableTextBlock" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_TableTextBlock" xlink:label="us-gaap_TableTextBlock-2" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_statement-statement-note-13-leases-tables" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_TableTextBlock-2" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_TableTextBlock" xlink:to="hstm_LesseeOperatingLeaseAssetsAndLiabilitiesTableTextBlock" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_TableTextBlock" xlink:to="us-gaap_LesseeOperatingLeaseLiabilityMaturityTableTextBlock" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-note-1-summary-of-significant-accounting-policies-details-textual" xlink:href="hstm-20241231.xsd#statement-note-1-summary-of-significant-accounting-policies-details-textual" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-note-1-summary-of-significant-accounting-policies-details-textual" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_CapitalizedSoftwareDevelopmentAmortizationPeriod" xlink:label="hstm_CapitalizedSoftwareDevelopmentAmortizationPeriod-2" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_ContractWithCustomerAssetSalesCommissionNoncurrent" xlink:label="hstm_ContractWithCustomerAssetSalesCommissionNoncurrent-2" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_NoteToFinancialStatementDetailsTextual" xlink:label="hstm_NoteToFinancialStatementDetailsTextual" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_NumberOfPossibleSourcesOfTaxableIncome" xlink:label="hstm_NumberOfPossibleSourcesOfTaxableIncome-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/srt/2024/elts/srt-2024.xsd#srt_MaximumMember" xlink:label="srt_MaximumMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/srt/2024/elts/srt-2024.xsd#srt_MinimumMember" xlink:label="srt_MinimumMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/srt/2024/elts/srt-2024.xsd#srt_RangeAxis" xlink:label="srt_RangeAxis" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/srt/2024/elts/srt-2024.xsd#srt_RangeMember" xlink:label="srt_RangeMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/srt/2024/elts/srt-2024.xsd#srt_WeightedAverageMember" xlink:label="srt_WeightedAverageMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_AdvertisingExpense" xlink:label="us-gaap_AdvertisingExpense-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_CapitalizedComputerSoftwareAccumulatedAmortization" xlink:label="us-gaap_CapitalizedComputerSoftwareAccumulatedAmortization-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_CapitalizedComputerSoftwareAmortization1" xlink:label="us-gaap_CapitalizedComputerSoftwareAmortization1-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_EquitySecuritiesWithoutReadilyDeterminableFairValueAmount" xlink:label="us-gaap_EquitySecuritiesWithoutReadilyDeterminableFairValueAmount-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_FiniteLivedIntangibleAssetUsefulLife" xlink:label="us-gaap_FiniteLivedIntangibleAssetUsefulLife-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ImpairmentOfIntangibleAssetsFinitelived" xlink:label="us-gaap_ImpairmentOfIntangibleAssetsFinitelived-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ImpairmentOfLongLivedAssetsHeldForUse" xlink:label="us-gaap_ImpairmentOfLongLivedAssetsHeldForUse-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_IncomeStatementLocationAxis" xlink:label="us-gaap_IncomeStatementLocationAxis" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_IncomeStatementLocationDomain" xlink:label="us-gaap_IncomeStatementLocationDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_SellingAndMarketingExpenseMember" xlink:label="us-gaap_SellingAndMarketingExpenseMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_NoteToFinancialStatementDetailsTextual" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeAxis" xlink:to="srt_RangeMember" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeStatementLocationAxis" xlink:to="us-gaap_IncomeStatementLocationDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="srt_RangeAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeAxis" xlink:to="srt_MinimumMember" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeAxis" xlink:to="srt_MaximumMember" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeAxis" xlink:to="srt_WeightedAverageMember" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_IncomeStatementLocationAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeStatementLocationAxis" xlink:to="us-gaap_SellingAndMarketingExpenseMember" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="hstm_ContractWithCustomerAssetSalesCommissionNoncurrent-2" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_CapitalizedComputerSoftwareAccumulatedAmortization-2" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="hstm_CapitalizedSoftwareDevelopmentAmortizationPeriod-2" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_CapitalizedComputerSoftwareAmortization1-2" xlink:type="arc"/>
    <link:presentationArc order="4" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_FiniteLivedIntangibleAssetUsefulLife-2" xlink:type="arc"/>
    <link:presentationArc order="5" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_ImpairmentOfIntangibleAssetsFinitelived-2" xlink:type="arc"/>
    <link:presentationArc order="6" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_ImpairmentOfLongLivedAssetsHeldForUse-2" xlink:type="arc"/>
    <link:presentationArc order="7" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_EquitySecuritiesWithoutReadilyDeterminableFairValueAmount-2" xlink:type="arc"/>
    <link:presentationArc order="8" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_AdvertisingExpense-2" xlink:type="arc"/>
    <link:presentationArc order="9" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="hstm_NumberOfPossibleSourcesOfTaxableIncome-2" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-note-1-summary-of-significant-accounting-policies-estimated-useful-lives-of-property-and-equipment-details" xlink:href="hstm-20241231.xsd#statement-note-1-summary-of-significant-accounting-policies-estimated-useful-lives-of-property-and-equipment-details" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-note-1-summary-of-significant-accounting-policies-estimated-useful-lives-of-property-and-equipment-details" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_statement-statement-note-1-summary-of-significant-accounting-policies-estimated-useful-lives-of-property-and-equipment-details" xlink:label="hstm_statement-statement-note-1-summary-of-significant-accounting-policies-estimated-useful-lives-of-property-and-equipment-details" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/srt/2024/elts/srt-2024.xsd#srt_MaximumMember" xlink:label="srt_MaximumMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/srt/2024/elts/srt-2024.xsd#srt_MinimumMember" xlink:label="srt_MinimumMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/srt/2024/elts/srt-2024.xsd#srt_RangeAxis" xlink:label="srt_RangeAxis" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/srt/2024/elts/srt-2024.xsd#srt_RangeMember" xlink:label="srt_RangeMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_EquipmentMember" xlink:label="us-gaap_EquipmentMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_FurnitureAndFixturesMember" xlink:label="us-gaap_FurnitureAndFixturesMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_PropertyPlantAndEquipmentByTypeAxis" xlink:label="us-gaap_PropertyPlantAndEquipmentByTypeAxis" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_PropertyPlantAndEquipmentTypeDomain" xlink:label="us-gaap_PropertyPlantAndEquipmentTypeDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_PropertyPlantAndEquipmentUsefulLife" xlink:label="us-gaap_PropertyPlantAndEquipmentUsefulLife" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_statement-statement-note-1-summary-of-significant-accounting-policies-estimated-useful-lives-of-property-and-equipment-details" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeAxis" xlink:to="srt_RangeMember" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PropertyPlantAndEquipmentByTypeAxis" xlink:to="us-gaap_PropertyPlantAndEquipmentTypeDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="srt_RangeAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeAxis" xlink:to="srt_MinimumMember" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_PropertyPlantAndEquipmentByTypeAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PropertyPlantAndEquipmentByTypeAxis" xlink:to="us-gaap_FurnitureAndFixturesMember" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeAxis" xlink:to="srt_MaximumMember" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PropertyPlantAndEquipmentByTypeAxis" xlink:to="us-gaap_EquipmentMember" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_PropertyPlantAndEquipmentUsefulLife" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-note-2-shareholders-equity-details-textual" xlink:href="hstm-20241231.xsd#statement-note-2-shareholders-equity-details-textual" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-note-2-shareholders-equity-details-textual" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_March2022ShareRepurchaseProgramMember" xlink:label="hstm_March2022ShareRepurchaseProgramMember" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_NoteToFinancialStatementDetailsTextual" xlink:label="hstm_NoteToFinancialStatementDetailsTextual" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_November2021ShareRepurchaseProgramMember" xlink:label="hstm_November2021ShareRepurchaseProgramMember" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_O2025Q1DividendsMember" xlink:label="hstm_O2025Q1DividendsMember" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_September2023ShareRepurchaseProgramMember" xlink:label="hstm_September2023ShareRepurchaseProgramMember" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_StockRepurchasedAveragePricePerShare" xlink:label="hstm_StockRepurchasedAveragePricePerShare-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/srt/2024/elts/srt-2024.xsd#srt_ShareRepurchaseProgramAxis" xlink:label="srt_ShareRepurchaseProgramAxis" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/srt/2024/elts/srt-2024.xsd#srt_ShareRepurchaseProgramDomain" xlink:label="srt_ShareRepurchaseProgramDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/srt/2024/elts/srt-2024.xsd#srt_StockRepurchaseProgramAuthorizedAmount1" xlink:label="srt_StockRepurchaseProgramAuthorizedAmount1-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_CommonStockDividendsPerShareDeclared" xlink:label="us-gaap_CommonStockDividendsPerShareDeclared-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_CommonStockSharesAuthorized" xlink:label="us-gaap_CommonStockSharesAuthorized-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_CommonStockSharesIssued" xlink:label="us-gaap_CommonStockSharesIssued-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_CommonStockSharesOutstanding" xlink:label="us-gaap_CommonStockSharesOutstanding-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DividendPayableDateToBePaidDayMonthAndYear" xlink:label="us-gaap_DividendPayableDateToBePaidDayMonthAndYear-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DividendsAxis" xlink:label="us-gaap_DividendsAxis" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DividendsDomain" xlink:label="us-gaap_DividendsDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DividendsPayableDateOfRecordDayMonthAndYear" xlink:label="us-gaap_DividendsPayableDateOfRecordDayMonthAndYear-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_PaymentsForRepurchaseOfCommonStock" xlink:label="us-gaap_PaymentsForRepurchaseOfCommonStock-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_PaymentsOfDividends" xlink:label="us-gaap_PaymentsOfDividends-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_PreferredStockSharesAuthorized" xlink:label="us-gaap_PreferredStockSharesAuthorized-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_PreferredStockSharesIssued" xlink:label="us-gaap_PreferredStockSharesIssued-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_PreferredStockSharesOutstanding" xlink:label="us-gaap_PreferredStockSharesOutstanding-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StockRepurchasedDuringPeriodShares" xlink:label="us-gaap_StockRepurchasedDuringPeriodShares-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_SubsequentEventMember" xlink:label="us-gaap_SubsequentEventMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_SubsequentEventTypeAxis" xlink:label="us-gaap_SubsequentEventTypeAxis" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_SubsequentEventTypeDomain" xlink:label="us-gaap_SubsequentEventTypeDomain" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_NoteToFinancialStatementDetailsTextual" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DividendsAxis" xlink:to="us-gaap_DividendsDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_SubsequentEventTypeAxis" xlink:to="us-gaap_SubsequentEventTypeDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ShareRepurchaseProgramAxis" xlink:to="srt_ShareRepurchaseProgramDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_SubsequentEventTypeAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_SubsequentEventTypeAxis" xlink:to="us-gaap_SubsequentEventMember" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_DividendsAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DividendsAxis" xlink:to="hstm_O2025Q1DividendsMember" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="srt_ShareRepurchaseProgramAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ShareRepurchaseProgramAxis" xlink:to="hstm_November2021ShareRepurchaseProgramMember" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ShareRepurchaseProgramAxis" xlink:to="hstm_March2022ShareRepurchaseProgramMember" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ShareRepurchaseProgramAxis" xlink:to="hstm_September2023ShareRepurchaseProgramMember" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="4" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_CommonStockSharesAuthorized-2" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_CommonStockSharesOutstanding-2" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_PreferredStockSharesAuthorized-2" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_PreferredStockSharesOutstanding-2" xlink:type="arc"/>
    <link:presentationArc order="4" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_CommonStockDividendsPerShareDeclared-2" xlink:type="arc"/>
    <link:presentationArc order="5" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_PaymentsOfDividends-2" xlink:type="arc"/>
    <link:presentationArc order="6" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="srt_StockRepurchaseProgramAuthorizedAmount1-2" xlink:type="arc"/>
    <link:presentationArc order="7" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_StockRepurchasedDuringPeriodShares-2" xlink:type="arc"/>
    <link:presentationArc order="8" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_PaymentsForRepurchaseOfCommonStock-2" xlink:type="arc"/>
    <link:presentationArc order="9" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="hstm_StockRepurchasedAveragePricePerShare-2" xlink:type="arc"/>
    <link:presentationArc order="10" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_CommonStockSharesIssued-2" xlink:type="arc"/>
    <link:presentationArc order="11" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_PreferredStockSharesIssued-2" xlink:type="arc"/>
    <link:presentationArc order="12" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_DividendPayableDateToBePaidDayMonthAndYear-2" xlink:type="arc"/>
    <link:presentationArc order="13" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_DividendsPayableDateOfRecordDayMonthAndYear-2" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-note-3-net-income-per-share-details-textual" xlink:href="hstm-20241231.xsd#statement-note-3-net-income-per-share-details-textual" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-note-3-net-income-per-share-details-textual" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_NoteToFinancialStatementDetailsTextual" xlink:label="hstm_NoteToFinancialStatementDetailsTextual" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_AntidilutiveSecuritiesExcludedFromComputationOfEarningsPerShareAmount" xlink:label="us-gaap_AntidilutiveSecuritiesExcludedFromComputationOfEarningsPerShareAmount-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_NoteToFinancialStatementDetailsTextual" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_AntidilutiveSecuritiesExcludedFromComputationOfEarningsPerShareAmount-2" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-note-5-revenue-recognition-1-details-textual" xlink:href="hstm-20241231.xsd#statement-note-5-revenue-recognition-1-details-textual" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-note-5-revenue-recognition-1-details-textual" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_NoteToFinancialStatementDetailsTextual" xlink:label="hstm_NoteToFinancialStatementDetailsTextual" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ContractWithCustomerLiabilityRevenueRecognized" xlink:label="us-gaap_ContractWithCustomerLiabilityRevenueRecognized-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_RevenueRemainingPerformanceObligation" xlink:label="us-gaap_RevenueRemainingPerformanceObligation-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_RevenueRemainingPerformanceObligationPercentage" xlink:label="us-gaap_RevenueRemainingPerformanceObligationPercentage-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_NoteToFinancialStatementDetailsTextual" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_ContractWithCustomerLiabilityRevenueRecognized-2" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_RevenueRemainingPerformanceObligation-2" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_RevenueRemainingPerformanceObligationPercentage-2" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-note-5-revenue-recognition-2-details-textual" xlink:href="hstm-20241231.xsd#statement-note-5-revenue-recognition-2-details-textual" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-note-5-revenue-recognition-2-details-textual" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_NoteToFinancialStatementDetailsTextual" xlink:label="hstm_NoteToFinancialStatementDetailsTextual" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_RevenueRemainingPerformanceObligationExpectedTimingOfSatisfactionPeriod1" xlink:label="us-gaap_RevenueRemainingPerformanceObligationExpectedTimingOfSatisfactionPeriod1-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_RevenueRemainingPerformanceObligationExpectedTimingOfSatisfactionStartDateAxis" xlink:label="us-gaap_RevenueRemainingPerformanceObligationExpectedTimingOfSatisfactionStartDateAxis" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_NoteToFinancialStatementDetailsTextual" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_RevenueRemainingPerformanceObligationExpectedTimingOfSatisfactionStartDateAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_RevenueRemainingPerformanceObligationExpectedTimingOfSatisfactionPeriod1-2" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-note-6-property-and-equipment-details-textual" xlink:href="hstm-20241231.xsd#statement-note-6-property-and-equipment-details-textual" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-note-6-property-and-equipment-details-textual" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_NoteToFinancialStatementDetailsTextual" xlink:label="hstm_NoteToFinancialStatementDetailsTextual" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_Depreciation" xlink:label="us-gaap_Depreciation-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_NoteToFinancialStatementDetailsTextual" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_Depreciation-2" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-note-7-goodwill-and-intangible-assets-details-textual" xlink:href="hstm-20241231.xsd#statement-note-7-goodwill-and-intangible-assets-details-textual" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-note-7-goodwill-and-intangible-assets-details-textual" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_NoteToFinancialStatementDetailsTextual" xlink:label="hstm_NoteToFinancialStatementDetailsTextual" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/srt/2024/elts/srt-2024.xsd#srt_MaximumMember" xlink:label="srt_MaximumMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/srt/2024/elts/srt-2024.xsd#srt_MinimumMember" xlink:label="srt_MinimumMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/srt/2024/elts/srt-2024.xsd#srt_RangeAxis" xlink:label="srt_RangeAxis" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/srt/2024/elts/srt-2024.xsd#srt_RangeMember" xlink:label="srt_RangeMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_AmortizationOfIntangibleAssets" xlink:label="us-gaap_AmortizationOfIntangibleAssets-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_CustomerRelationshipsMember" xlink:label="us-gaap_CustomerRelationshipsMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_FiniteLivedIntangibleAssetUsefulLife" xlink:label="us-gaap_FiniteLivedIntangibleAssetUsefulLife-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis" xlink:label="us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain" xlink:label="us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_OtherIntangibleAssetsMember" xlink:label="us-gaap_OtherIntangibleAssetsMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_NoteToFinancialStatementDetailsTextual" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeAxis" xlink:to="srt_RangeMember" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis" xlink:to="us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="srt_RangeAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeAxis" xlink:to="srt_MinimumMember" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis" xlink:to="us-gaap_CustomerRelationshipsMember" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeAxis" xlink:to="srt_MaximumMember" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis" xlink:to="us-gaap_OtherIntangibleAssetsMember" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_FiniteLivedIntangibleAssetUsefulLife-2" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_AmortizationOfIntangibleAssets-2" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-note-8-business-combinations-details-textual" xlink:href="hstm-20241231.xsd#statement-note-8-business-combinations-details-textual" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-note-8-business-combinations-details-textual" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_BusinessCombinationConsiderationTransferredAmountHeldInEscrow" xlink:label="hstm_BusinessCombinationConsiderationTransferredAmountHeldInEscrow-2" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_CloudCMELLCMember" xlink:label="hstm_CloudCMELLCMember" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_ElectronicEducationDocumentationSystemLlcMember" xlink:label="hstm_ElectronicEducationDocumentationSystemLlcMember" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_NoteToFinancialStatementDetailsTextual" xlink:label="hstm_NoteToFinancialStatementDetailsTextual" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_TotalClinicalPlacementSystemAndTheClinicalHubMember" xlink:label="hstm_TotalClinicalPlacementSystemAndTheClinicalHubMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_BusinessAcquisitionAcquireeDomain" xlink:label="us-gaap_BusinessAcquisitionAcquireeDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_BusinessAcquisitionAxis" xlink:label="us-gaap_BusinessAcquisitionAxis" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_BusinessAcquisitionPercentageOfVotingInterestsAcquired" xlink:label="us-gaap_BusinessAcquisitionPercentageOfVotingInterestsAcquired-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_BusinessCombinationAcquisitionRelatedCosts" xlink:label="us-gaap_BusinessCombinationAcquisitionRelatedCosts-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_BusinessCombinationConsiderationTransferredEquityInterestsIssuedAndIssuable" xlink:label="us-gaap_BusinessCombinationConsiderationTransferredEquityInterestsIssuedAndIssuable-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_BusinessCombinationLiabilitiesArisingFromContingenciesAmountRecognized" xlink:label="us-gaap_BusinessCombinationLiabilitiesArisingFromContingenciesAmountRecognized-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedIntangibleAssetsOtherThanGoodwill" xlink:label="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedIntangibleAssetsOtherThanGoodwill-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNet" xlink:label="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNet-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_BusinessCombinationStepAcquisitionEquityInterestInAcquireePercentage" xlink:label="us-gaap_BusinessCombinationStepAcquisitionEquityInterestInAcquireePercentage-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_Goodwill" xlink:label="us-gaap_Goodwill-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_PaymentsToAcquireBusinessesGross" xlink:label="us-gaap_PaymentsToAcquireBusinessesGross-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_NoteToFinancialStatementDetailsTextual" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionAxis" xlink:to="us-gaap_BusinessAcquisitionAcquireeDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_BusinessAcquisitionAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionAxis" xlink:to="hstm_TotalClinicalPlacementSystemAndTheClinicalHubMember" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionAxis" xlink:to="hstm_ElectronicEducationDocumentationSystemLlcMember" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionAxis" xlink:to="hstm_CloudCMELLCMember" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_PaymentsToAcquireBusinessesGross-2" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_BusinessCombinationLiabilitiesArisingFromContingenciesAmountRecognized-2" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="hstm_BusinessCombinationConsiderationTransferredAmountHeldInEscrow-2" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_BusinessCombinationAcquisitionRelatedCosts-2" xlink:type="arc"/>
    <link:presentationArc order="4" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNet-2" xlink:type="arc"/>
    <link:presentationArc order="5" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedIntangibleAssetsOtherThanGoodwill-2" xlink:type="arc"/>
    <link:presentationArc order="6" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_Goodwill-2" xlink:type="arc"/>
    <link:presentationArc order="7" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_BusinessAcquisitionPercentageOfVotingInterestsAcquired-2" xlink:type="arc"/>
    <link:presentationArc order="8" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_BusinessCombinationConsiderationTransferredEquityInterestsIssuedAndIssuable-2" xlink:type="arc"/>
    <link:presentationArc order="9" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_BusinessCombinationStepAcquisitionEquityInterestInAcquireePercentage-2" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-note-9-income-taxes-details-textual" xlink:href="hstm-20241231.xsd#statement-note-9-income-taxes-details-textual" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-note-9-income-taxes-details-textual" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_NoteToFinancialStatementDetailsTextual" xlink:label="hstm_NoteToFinancialStatementDetailsTextual" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DeferredTaxAssetsValuationAllowance" xlink:label="us-gaap_DeferredTaxAssetsValuationAllowance-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DomesticCountryMember" xlink:label="us-gaap_DomesticCountryMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ForeignCountryMember" xlink:label="us-gaap_ForeignCountryMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_IncomeTaxAuthorityAxis" xlink:label="us-gaap_IncomeTaxAuthorityAxis" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_IncomeTaxAuthorityDomain" xlink:label="us-gaap_IncomeTaxAuthorityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_OperatingLossCarryforwards" xlink:label="us-gaap_OperatingLossCarryforwards-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StateAndLocalJurisdictionMember" xlink:label="us-gaap_StateAndLocalJurisdictionMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_UnrecognizedTaxBenefitsThatWouldImpactEffectiveTaxRate" xlink:label="us-gaap_UnrecognizedTaxBenefitsThatWouldImpactEffectiveTaxRate-2" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_NoteToFinancialStatementDetailsTextual" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxAuthorityAxis" xlink:to="us-gaap_IncomeTaxAuthorityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_IncomeTaxAuthorityAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxAuthorityAxis" xlink:to="us-gaap_DomesticCountryMember" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxAuthorityAxis" xlink:to="us-gaap_StateAndLocalJurisdictionMember" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxAuthorityAxis" xlink:to="us-gaap_ForeignCountryMember" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_DeferredTaxAssetsValuationAllowance-2" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_OperatingLossCarryforwards-2" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_UnrecognizedTaxBenefitsThatWouldImpactEffectiveTaxRate-2" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-note-10-stockbased-compensation-details-textual" xlink:href="hstm-20241231.xsd#statement-note-10-stockbased-compensation-details-textual" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-note-10-stockbased-compensation-details-textual" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_NoteToFinancialStatementDetailsTextual" xlink:label="hstm_NoteToFinancialStatementDetailsTextual" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_StockOptionsAndRestrictedStockUnitsMember" xlink:label="hstm_StockOptionsAndRestrictedStockUnitsMember" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_The2016PlanMember" xlink:label="hstm_The2016PlanMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_AwardTypeAxis" xlink:label="us-gaap_AwardTypeAxis" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognized" xlink:label="us-gaap_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognized-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedPeriodForRecognition1" xlink:label="us-gaap_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedPeriodForRecognition1-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_PlanNameAxis" xlink:label="us-gaap_PlanNameAxis" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_PlanNameDomain" xlink:label="us-gaap_PlanNameDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_RestrictedStockMember" xlink:label="us-gaap_RestrictedStockMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardAwardVestingPeriod1" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardAwardVestingPeriod1-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodTotalFairValue" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodTotalFairValue-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardNumberOfSharesAvailableForGrant" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardNumberOfSharesAvailableForGrant-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:label="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsOutstandingWeightedAverageRemainingContractualTerm2" xlink:label="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsOutstandingWeightedAverageRemainingContractualTerm2-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_NoteToFinancialStatementDetailsTextual" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AwardTypeAxis" xlink:to="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PlanNameAxis" xlink:to="us-gaap_PlanNameDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_PlanNameAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PlanNameAxis" xlink:to="hstm_The2016PlanMember" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_AwardTypeAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AwardTypeAxis" xlink:to="us-gaap_RestrictedStockMember" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AwardTypeAxis" xlink:to="hstm_StockOptionsAndRestrictedStockUnitsMember" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardAwardVestingPeriod1-2" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardNumberOfSharesAvailableForGrant-2" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsOutstandingWeightedAverageRemainingContractualTerm2-2" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodTotalFairValue-2" xlink:type="arc"/>
    <link:presentationArc order="4" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognized-2" xlink:type="arc"/>
    <link:presentationArc order="5" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedPeriodForRecognition1-2" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-note-11-employee-benefit-plan-details-textual" xlink:href="hstm-20241231.xsd#statement-note-11-employee-benefit-plan-details-textual" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-note-11-employee-benefit-plan-details-textual" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_NoteToFinancialStatementDetailsTextual" xlink:label="hstm_NoteToFinancialStatementDetailsTextual" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DefinedContributionPlanEmployerDiscretionaryContributionAmount" xlink:label="us-gaap_DefinedContributionPlanEmployerDiscretionaryContributionAmount-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_NoteToFinancialStatementDetailsTextual" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_DefinedContributionPlanEmployerDiscretionaryContributionAmount-2" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-note-12-debt-details-textual" xlink:href="hstm-20241231.xsd#statement-note-12-debt-details-textual" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-note-12-debt-details-textual" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_DebtInstrumentCovenantInterestCoverageRatio" xlink:label="hstm_DebtInstrumentCovenantInterestCoverageRatio-2" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_DebtInstrumentCovenantMaximumFundedDebtLeverageRatio" xlink:label="hstm_DebtInstrumentCovenantMaximumFundedDebtLeverageRatio-2" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_LetterOfCreditSubfacilityMember" xlink:label="hstm_LetterOfCreditSubfacilityMember" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_LineOfCreditFacilityIncreasedFacilitySizeDueToAccordionFeature" xlink:label="hstm_LineOfCreditFacilityIncreasedFacilitySizeDueToAccordionFeature-2" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_LineOfCreditFacilityPercentageOfApplicableMarginForBorrowings" xlink:label="hstm_LineOfCreditFacilityPercentageOfApplicableMarginForBorrowings-2" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_NoteToFinancialStatementDetailsTextual" xlink:label="hstm_NoteToFinancialStatementDetailsTextual" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_SwingLineSubfacilityMember" xlink:label="hstm_SwingLineSubfacilityMember" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_ThirdAmendmentMember" xlink:label="hstm_ThirdAmendmentMember" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_TruistBankMember" xlink:label="hstm_TruistBankMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/srt/2024/elts/srt-2024.xsd#srt_MaximumMember" xlink:label="srt_MaximumMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/srt/2024/elts/srt-2024.xsd#srt_MinimumMember" xlink:label="srt_MinimumMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/srt/2024/elts/srt-2024.xsd#srt_RangeAxis" xlink:label="srt_RangeAxis" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/srt/2024/elts/srt-2024.xsd#srt_RangeMember" xlink:label="srt_RangeMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_BaseRateMember" xlink:label="us-gaap_BaseRateMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_CreditFacilityAxis" xlink:label="us-gaap_CreditFacilityAxis" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_CreditFacilityDomain" xlink:label="us-gaap_CreditFacilityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DebtInstrumentBasisSpreadOnVariableRate1" xlink:label="us-gaap_DebtInstrumentBasisSpreadOnVariableRate1-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DebtInstrumentCarryingAmount" xlink:label="us-gaap_DebtInstrumentCarryingAmount-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_FederalFundsEffectiveSwapRateMember" xlink:label="us-gaap_FederalFundsEffectiveSwapRateMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_LineOfCredit" xlink:label="us-gaap_LineOfCredit-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_LineOfCreditFacilityAxis" xlink:label="us-gaap_LineOfCreditFacilityAxis" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_LineOfCreditFacilityLenderDomain" xlink:label="us-gaap_LineOfCreditFacilityLenderDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_LineOfCreditFacilityMaximumBorrowingCapacity" xlink:label="us-gaap_LineOfCreditFacilityMaximumBorrowingCapacity-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_LineOfCreditFacilityUnusedCapacityCommitmentFeePercentage" xlink:label="us-gaap_LineOfCreditFacilityUnusedCapacityCommitmentFeePercentage-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_LongtermDebtTypeAxis" xlink:label="us-gaap_LongtermDebtTypeAxis" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_LongtermDebtTypeDomain" xlink:label="us-gaap_LongtermDebtTypeDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_RevolvingCreditFacilityMember" xlink:label="us-gaap_RevolvingCreditFacilityMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_SecuredOvernightFinancingRateSofrOvernightIndexSwapRateMember" xlink:label="us-gaap_SecuredOvernightFinancingRateSofrOvernightIndexSwapRateMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ShortTermDebtTypeAxis" xlink:label="us-gaap_ShortTermDebtTypeAxis" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ShortTermDebtTypeDomain" xlink:label="us-gaap_ShortTermDebtTypeDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_VariableRateAxis" xlink:label="us-gaap_VariableRateAxis" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_VariableRateDomain" xlink:label="us-gaap_VariableRateDomain" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_NoteToFinancialStatementDetailsTextual" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeAxis" xlink:to="srt_RangeMember" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShortTermDebtTypeAxis" xlink:to="us-gaap_ShortTermDebtTypeDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CreditFacilityAxis" xlink:to="us-gaap_CreditFacilityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LongtermDebtTypeAxis" xlink:to="us-gaap_LongtermDebtTypeDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_VariableRateAxis" xlink:to="us-gaap_VariableRateDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LineOfCreditFacilityAxis" xlink:to="us-gaap_LineOfCreditFacilityLenderDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_LongtermDebtTypeAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LongtermDebtTypeAxis" xlink:to="hstm_ThirdAmendmentMember" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_CreditFacilityAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CreditFacilityAxis" xlink:to="us-gaap_RevolvingCreditFacilityMember" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_LineOfCreditFacilityAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LineOfCreditFacilityAxis" xlink:to="hstm_TruistBankMember" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_ShortTermDebtTypeAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShortTermDebtTypeAxis" xlink:to="hstm_SwingLineSubfacilityMember" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShortTermDebtTypeAxis" xlink:to="hstm_LetterOfCreditSubfacilityMember" xlink:type="arc"/>
    <link:presentationArc order="4" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_VariableRateAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_VariableRateAxis" xlink:to="us-gaap_FederalFundsEffectiveSwapRateMember" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_VariableRateAxis" xlink:to="us-gaap_BaseRateMember" xlink:type="arc"/>
    <link:presentationArc order="5" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="srt_RangeAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeAxis" xlink:to="srt_MinimumMember" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_VariableRateAxis" xlink:to="us-gaap_SecuredOvernightFinancingRateSofrOvernightIndexSwapRateMember" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeAxis" xlink:to="srt_MaximumMember" xlink:type="arc"/>
    <link:presentationArc order="6" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="7" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_DebtInstrumentCarryingAmount-2" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_LineOfCreditFacilityMaximumBorrowingCapacity-2" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="hstm_LineOfCreditFacilityIncreasedFacilitySizeDueToAccordionFeature-2" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_DebtInstrumentBasisSpreadOnVariableRate1-2" xlink:type="arc"/>
    <link:presentationArc order="4" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="hstm_LineOfCreditFacilityPercentageOfApplicableMarginForBorrowings-2" xlink:type="arc"/>
    <link:presentationArc order="5" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_LineOfCreditFacilityUnusedCapacityCommitmentFeePercentage-2" xlink:type="arc"/>
    <link:presentationArc order="6" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="hstm_DebtInstrumentCovenantMaximumFundedDebtLeverageRatio-2" xlink:type="arc"/>
    <link:presentationArc order="7" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="hstm_DebtInstrumentCovenantInterestCoverageRatio-2" xlink:type="arc"/>
    <link:presentationArc order="8" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_LineOfCredit-2" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-note-13-leases-details-textual" xlink:href="hstm-20241231.xsd#statement-note-13-leases-details-textual" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-note-13-leases-details-textual" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_NoteToFinancialStatementDetailsTextual" xlink:label="hstm_NoteToFinancialStatementDetailsTextual" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_OperatingLeaseCost" xlink:label="us-gaap_OperatingLeaseCost-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_OperatingLeasePayments" xlink:label="us-gaap_OperatingLeasePayments-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_OperatingLeaseWeightedAverageDiscountRatePercent" xlink:label="us-gaap_OperatingLeaseWeightedAverageDiscountRatePercent-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_OperatingLeaseWeightedAverageRemainingLeaseTerm1" xlink:label="us-gaap_OperatingLeaseWeightedAverageRemainingLeaseTerm1-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_NoteToFinancialStatementDetailsTextual" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_OperatingLeaseCost-2" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_OperatingLeasePayments-2" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_OperatingLeaseWeightedAverageRemainingLeaseTerm1-2" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_OperatingLeaseWeightedAverageDiscountRatePercent-2" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-note-7-goodwill-and-intangible-assets-expected-annual-amortization-expense-details" xlink:href="hstm-20241231.xsd#statement-note-7-goodwill-and-intangible-assets-expected-annual-amortization-expense-details" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-note-7-goodwill-and-intangible-assets-expected-annual-amortization-expense-details" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_statement-statement-note-7-goodwill-and-intangible-assets-expected-annual-amortization-expense-details" xlink:label="hstm_statement-statement-note-7-goodwill-and-intangible-assets-expected-annual-amortization-expense-details" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseAfterYearFive" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseAfterYearFive-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseNextTwelveMonths" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseNextTwelveMonths-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearFive" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearFive-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearFour" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearFour-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearThree" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearThree-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearTwo" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearTwo-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_FiniteLivedIntangibleAssetsNet" xlink:label="us-gaap_FiniteLivedIntangibleAssetsNet-3" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_statement-statement-note-7-goodwill-and-intangible-assets-expected-annual-amortization-expense-details" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseNextTwelveMonths-2" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearTwo-2" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearThree-2" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearFour-2" xlink:type="arc"/>
    <link:presentationArc order="4" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearFive-2" xlink:type="arc"/>
    <link:presentationArc order="5" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseAfterYearFive-2" xlink:type="arc"/>
    <link:presentationArc order="6" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_FiniteLivedIntangibleAssetsNet-3" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-note-13-leases-maturities-of-lease-liabilities-details" xlink:href="hstm-20241231.xsd#statement-note-13-leases-maturities-of-lease-liabilities-details" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-note-13-leases-maturities-of-lease-liabilities-details" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_statement-statement-note-13-leases-maturities-of-lease-liabilities-details" xlink:label="hstm_statement-statement-note-13-leases-maturities-of-lease-liabilities-details" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_LesseeOperatingLeaseLiabilityPaymentsDue" xlink:label="us-gaap_LesseeOperatingLeaseLiabilityPaymentsDue-3" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_LesseeOperatingLeaseLiabilityPaymentsDueAfterYearFive" xlink:label="us-gaap_LesseeOperatingLeaseLiabilityPaymentsDueAfterYearFive-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_LesseeOperatingLeaseLiabilityPaymentsDueNextTwelveMonths" xlink:label="us-gaap_LesseeOperatingLeaseLiabilityPaymentsDueNextTwelveMonths-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_LesseeOperatingLeaseLiabilityPaymentsDueYearFive" xlink:label="us-gaap_LesseeOperatingLeaseLiabilityPaymentsDueYearFive-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_LesseeOperatingLeaseLiabilityPaymentsDueYearFour" xlink:label="us-gaap_LesseeOperatingLeaseLiabilityPaymentsDueYearFour-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_LesseeOperatingLeaseLiabilityPaymentsDueYearThree" xlink:label="us-gaap_LesseeOperatingLeaseLiabilityPaymentsDueYearThree-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_LesseeOperatingLeaseLiabilityPaymentsDueYearTwo" xlink:label="us-gaap_LesseeOperatingLeaseLiabilityPaymentsDueYearTwo-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_LesseeOperatingLeaseLiabilityUndiscountedExcessAmount" xlink:label="us-gaap_LesseeOperatingLeaseLiabilityUndiscountedExcessAmount-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_OperatingLeaseLiability" xlink:label="us-gaap_OperatingLeaseLiability-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_statement-statement-note-13-leases-maturities-of-lease-liabilities-details" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_LesseeOperatingLeaseLiabilityPaymentsDueNextTwelveMonths-2" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_LesseeOperatingLeaseLiabilityPaymentsDueYearTwo-2" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_LesseeOperatingLeaseLiabilityPaymentsDueYearThree-2" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_LesseeOperatingLeaseLiabilityPaymentsDueYearFour-2" xlink:type="arc"/>
    <link:presentationArc order="4" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_LesseeOperatingLeaseLiabilityPaymentsDueYearFive-2" xlink:type="arc"/>
    <link:presentationArc order="5" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_LesseeOperatingLeaseLiabilityPaymentsDueAfterYearFive-2" xlink:type="arc"/>
    <link:presentationArc order="6" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_LesseeOperatingLeaseLiabilityPaymentsDue-3" xlink:type="arc"/>
    <link:presentationArc order="7" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_LesseeOperatingLeaseLiabilityUndiscountedExcessAmount-2" xlink:type="arc"/>
    <link:presentationArc order="8" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_OperatingLeaseLiability-2" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-note-1-summary-of-significant-accounting-policies-changes-in-the-allowance-for-doubtful-accounts-and-the-amounts-charged-to-bad-debt-expense-details" xlink:href="hstm-20241231.xsd#statement-note-1-summary-of-significant-accounting-policies-changes-in-the-allowance-for-doubtful-accounts-and-the-amounts-charged-to-bad-debt-expense-details" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-note-1-summary-of-significant-accounting-policies-changes-in-the-allowance-for-doubtful-accounts-and-the-amounts-charged-to-bad-debt-expense-details" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_statement-statement-note-1-summary-of-significant-accounting-policies-changes-in-the-allowance-for-doubtful-accounts-and-the-amounts-charged-to-bad-debt-expense-details" xlink:label="hstm_statement-statement-note-1-summary-of-significant-accounting-policies-changes-in-the-allowance-for-doubtful-accounts-and-the-amounts-charged-to-bad-debt-expense-details" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_AllowanceForDoubtfulAccountsReceivableCurrent" xlink:label="us-gaap_AllowanceForDoubtfulAccountsReceivableCurrent-4" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_AllowanceForDoubtfulAccountsReceivableCurrent" xlink:label="us-gaap_AllowanceForDoubtfulAccountsReceivableCurrent-5" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_AllowanceForDoubtfulAccountsReceivableWriteOffs" xlink:label="us-gaap_AllowanceForDoubtfulAccountsReceivableWriteOffs-n8" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ProvisionForDoubtfulAccounts" xlink:label="us-gaap_ProvisionForDoubtfulAccounts-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_statement-statement-note-1-summary-of-significant-accounting-policies-changes-in-the-allowance-for-doubtful-accounts-and-the-amounts-charged-to-bad-debt-expense-details" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/periodStartLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_AllowanceForDoubtfulAccountsReceivableCurrent-4" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_ProvisionForDoubtfulAccounts-2" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_AllowanceForDoubtfulAccountsReceivableWriteOffs-n8" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/periodEndLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_AllowanceForDoubtfulAccountsReceivableCurrent-5" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-note-7-goodwill-and-intangible-assets-changes-in-carrying-amount-of-goodwill-details" xlink:href="hstm-20241231.xsd#statement-note-7-goodwill-and-intangible-assets-changes-in-carrying-amount-of-goodwill-details" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-note-7-goodwill-and-intangible-assets-changes-in-carrying-amount-of-goodwill-details" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_TheClinicalHubMember" xlink:label="hstm_TheClinicalHubMember" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_TotalClinicalPlacementSystemTcpsMember" xlink:label="hstm_TotalClinicalPlacementSystemTcpsMember" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_statement-statement-note-7-goodwill-and-intangible-assets-changes-in-carrying-amount-of-goodwill-details" xlink:label="hstm_statement-statement-note-7-goodwill-and-intangible-assets-changes-in-carrying-amount-of-goodwill-details" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_BusinessAcquisitionAcquireeDomain" xlink:label="us-gaap_BusinessAcquisitionAcquireeDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_BusinessAcquisitionAxis" xlink:label="us-gaap_BusinessAcquisitionAxis" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_Goodwill" xlink:label="us-gaap_Goodwill-4" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_Goodwill" xlink:label="us-gaap_Goodwill-5" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_GoodwillAcquiredDuringPeriod" xlink:label="us-gaap_GoodwillAcquiredDuringPeriod" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_GoodwillForeignCurrencyTranslationGainLoss" xlink:label="us-gaap_GoodwillForeignCurrencyTranslationGainLoss" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_GoodwillPurchaseAccountingAdjustments" xlink:label="us-gaap_GoodwillPurchaseAccountingAdjustments" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_statement-statement-note-7-goodwill-and-intangible-assets-changes-in-carrying-amount-of-goodwill-details" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionAxis" xlink:to="us-gaap_BusinessAcquisitionAcquireeDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_BusinessAcquisitionAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionAxis" xlink:to="hstm_TotalClinicalPlacementSystemTcpsMember" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionAxis" xlink:to="hstm_TheClinicalHubMember" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/periodStartLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_Goodwill-4" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_GoodwillAcquiredDuringPeriod" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_GoodwillForeignCurrencyTranslationGainLoss" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/periodEndLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_Goodwill-5" xlink:type="arc"/>
    <link:presentationArc order="4" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_GoodwillPurchaseAccountingAdjustments" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-consolidated-balance-sheets" xlink:href="hstm-20241231.xsd#statement-consolidated-balance-sheets" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-consolidated-balance-sheets" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_PrepaidSoftwareMaintenanceAndSubscriptions" xlink:label="hstm_PrepaidSoftwareMaintenanceAndSubscriptions" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_AccountsPayableCurrent" xlink:label="us-gaap_AccountsPayableCurrent" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_AccountsReceivableNetCurrent" xlink:label="us-gaap_AccountsReceivableNetCurrent" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_AccruedLiabilitiesCurrent" xlink:label="us-gaap_AccruedLiabilitiesCurrent" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_AccruedRoyaltiesCurrent" xlink:label="us-gaap_AccruedRoyaltiesCurrent" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_AccumulatedOtherComprehensiveIncomeLossNetOfTax" xlink:label="us-gaap_AccumulatedOtherComprehensiveIncomeLossNetOfTax" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_Assets" xlink:label="us-gaap_Assets-3" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_AssetsAbstract" xlink:label="us-gaap_AssetsAbstract" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_AssetsCurrent" xlink:label="us-gaap_AssetsCurrent-3" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_AvailableForSaleSecuritiesDebtSecuritiesCurrent" xlink:label="us-gaap_AvailableForSaleSecuritiesDebtSecuritiesCurrent" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_CapitalizedComputerSoftwareNet" xlink:label="us-gaap_CapitalizedComputerSoftwareNet" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_CashAndCashEquivalentsAtCarryingValue" xlink:label="us-gaap_CashAndCashEquivalentsAtCarryingValue" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_CommitmentsAndContingencies" xlink:label="us-gaap_CommitmentsAndContingencies" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_CommonStocksIncludingAdditionalPaidInCapital" xlink:label="us-gaap_CommonStocksIncludingAdditionalPaidInCapital" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ContractWithCustomerLiabilityCurrent" xlink:label="us-gaap_ContractWithCustomerLiabilityCurrent" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ContractWithCustomerLiabilityNoncurrent" xlink:label="us-gaap_ContractWithCustomerLiabilityNoncurrent" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_CustomerRelatedIntangibleAssetsMember" xlink:label="us-gaap_CustomerRelatedIntangibleAssetsMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DeferredIncomeTaxLiabilitiesNet" xlink:label="us-gaap_DeferredIncomeTaxLiabilitiesNet" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_EmployeeRelatedLiabilitiesCurrent" xlink:label="us-gaap_EmployeeRelatedLiabilitiesCurrent" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis" xlink:label="us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain" xlink:label="us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_Goodwill" xlink:label="us-gaap_Goodwill" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_IntangibleAssetsNetExcludingGoodwill" xlink:label="us-gaap_IntangibleAssetsNetExcludingGoodwill" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_LiabilitiesAndStockholdersEquity" xlink:label="us-gaap_LiabilitiesAndStockholdersEquity-3" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_LiabilitiesAndStockholdersEquityAbstract" xlink:label="us-gaap_LiabilitiesAndStockholdersEquityAbstract" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_LiabilitiesCurrent" xlink:label="us-gaap_LiabilitiesCurrent-3" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_OperatingLeaseLiabilityNoncurrent" xlink:label="us-gaap_OperatingLeaseLiabilityNoncurrent" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_OperatingLeaseRightOfUseAsset" xlink:label="us-gaap_OperatingLeaseRightOfUseAsset" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_OtherAssetsCurrent" xlink:label="us-gaap_OtherAssetsCurrent" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_OtherAssetsNoncurrent" xlink:label="us-gaap_OtherAssetsNoncurrent" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_OtherIntangibleAssetsMember" xlink:label="us-gaap_OtherIntangibleAssetsMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_OtherLiabilitiesNoncurrent" xlink:label="us-gaap_OtherLiabilitiesNoncurrent" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_PreferredStockValue" xlink:label="us-gaap_PreferredStockValue" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_PrepaidRoyalties" xlink:label="us-gaap_PrepaidRoyalties" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_PropertyPlantAndEquipmentNet" xlink:label="us-gaap_PropertyPlantAndEquipmentNet" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_RetainedEarningsAccumulatedDeficit" xlink:label="us-gaap_RetainedEarningsAccumulatedDeficit" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementOfFinancialPositionAbstract" xlink:label="us-gaap_StatementOfFinancialPositionAbstract" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StockholdersEquity" xlink:label="us-gaap_StockholdersEquity-3" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StockholdersEquityAbstract" xlink:label="us-gaap_StockholdersEquityAbstract" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_UnbilledReceivablesCurrent" xlink:label="us-gaap_UnbilledReceivablesCurrent" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementOfFinancialPositionAbstract" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis" xlink:to="us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis" xlink:to="us-gaap_CustomerRelatedIntangibleAssetsMember" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis" xlink:to="us-gaap_OtherIntangibleAssetsMember" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_AssetsAbstract" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AssetsAbstract" xlink:to="us-gaap_CashAndCashEquivalentsAtCarryingValue" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AssetsAbstract" xlink:to="us-gaap_AvailableForSaleSecuritiesDebtSecuritiesCurrent" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AssetsAbstract" xlink:to="us-gaap_AccountsReceivableNetCurrent" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AssetsAbstract" xlink:to="us-gaap_UnbilledReceivablesCurrent" xlink:type="arc"/>
    <link:presentationArc order="4" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AssetsAbstract" xlink:to="us-gaap_PrepaidRoyalties" xlink:type="arc"/>
    <link:presentationArc order="5" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AssetsAbstract" xlink:to="hstm_PrepaidSoftwareMaintenanceAndSubscriptions" xlink:type="arc"/>
    <link:presentationArc order="6" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AssetsAbstract" xlink:to="us-gaap_OtherAssetsCurrent" xlink:type="arc"/>
    <link:presentationArc order="7" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AssetsAbstract" xlink:to="us-gaap_AssetsCurrent-3" xlink:type="arc"/>
    <link:presentationArc order="8" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AssetsAbstract" xlink:to="us-gaap_PropertyPlantAndEquipmentNet" xlink:type="arc"/>
    <link:presentationArc order="9" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AssetsAbstract" xlink:to="us-gaap_CapitalizedComputerSoftwareNet" xlink:type="arc"/>
    <link:presentationArc order="10" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AssetsAbstract" xlink:to="us-gaap_OperatingLeaseRightOfUseAsset" xlink:type="arc"/>
    <link:presentationArc order="11" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AssetsAbstract" xlink:to="us-gaap_Goodwill" xlink:type="arc"/>
    <link:presentationArc order="12" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AssetsAbstract" xlink:to="us-gaap_IntangibleAssetsNetExcludingGoodwill" xlink:type="arc"/>
    <link:presentationArc order="13" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AssetsAbstract" xlink:to="us-gaap_OtherAssetsNoncurrent" xlink:type="arc"/>
    <link:presentationArc order="14" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AssetsAbstract" xlink:to="us-gaap_Assets-3" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_LiabilitiesAndStockholdersEquityAbstract" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LiabilitiesAndStockholdersEquityAbstract" xlink:to="us-gaap_AccountsPayableCurrent" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LiabilitiesAndStockholdersEquityAbstract" xlink:to="us-gaap_AccruedRoyaltiesCurrent" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LiabilitiesAndStockholdersEquityAbstract" xlink:to="us-gaap_AccruedLiabilitiesCurrent" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LiabilitiesAndStockholdersEquityAbstract" xlink:to="us-gaap_EmployeeRelatedLiabilitiesCurrent" xlink:type="arc"/>
    <link:presentationArc order="4" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LiabilitiesAndStockholdersEquityAbstract" xlink:to="us-gaap_ContractWithCustomerLiabilityCurrent" xlink:type="arc"/>
    <link:presentationArc order="5" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LiabilitiesAndStockholdersEquityAbstract" xlink:to="us-gaap_LiabilitiesCurrent-3" xlink:type="arc"/>
    <link:presentationArc order="6" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LiabilitiesAndStockholdersEquityAbstract" xlink:to="us-gaap_DeferredIncomeTaxLiabilitiesNet" xlink:type="arc"/>
    <link:presentationArc order="7" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LiabilitiesAndStockholdersEquityAbstract" xlink:to="us-gaap_ContractWithCustomerLiabilityNoncurrent" xlink:type="arc"/>
    <link:presentationArc order="8" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LiabilitiesAndStockholdersEquityAbstract" xlink:to="us-gaap_OperatingLeaseLiabilityNoncurrent" xlink:type="arc"/>
    <link:presentationArc order="9" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LiabilitiesAndStockholdersEquityAbstract" xlink:to="us-gaap_OtherLiabilitiesNoncurrent" xlink:type="arc"/>
    <link:presentationArc order="10" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LiabilitiesAndStockholdersEquityAbstract" xlink:to="us-gaap_CommitmentsAndContingencies" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_StockholdersEquityAbstract" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StockholdersEquityAbstract" xlink:to="us-gaap_PreferredStockValue" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StockholdersEquityAbstract" xlink:to="us-gaap_CommonStocksIncludingAdditionalPaidInCapital" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StockholdersEquityAbstract" xlink:to="us-gaap_RetainedEarningsAccumulatedDeficit" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StockholdersEquityAbstract" xlink:to="us-gaap_AccumulatedOtherComprehensiveIncomeLossNetOfTax" xlink:type="arc"/>
    <link:presentationArc order="4" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StockholdersEquityAbstract" xlink:to="us-gaap_StockholdersEquity-3" xlink:type="arc"/>
    <link:presentationArc order="5" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StockholdersEquityAbstract" xlink:to="us-gaap_LiabilitiesAndStockholdersEquity-3" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-consolidated-statements-of-cash-flows" xlink:href="hstm-20241231.xsd#statement-consolidated-statements-of-cash-flows" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-consolidated-statements-of-cash-flows" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_CapitalizedSoftwareDevelopmentExpendituresIncurredButNotYetPaid" xlink:label="hstm_CapitalizedSoftwareDevelopmentExpendituresIncurredButNotYetPaid" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_ChangeInFairValueOfNonMarketableEquityInvestments" xlink:label="hstm_ChangeInFairValueOfNonMarketableEquityInvestments" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_IncreaseDecreaseInDeferredCommissions" xlink:label="hstm_IncreaseDecreaseInDeferredCommissions-n8" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_PaymentsForDebtIssueCosts" xlink:label="hstm_PaymentsForDebtIssueCosts-n8" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_ProceedsFromTheSaleOfNonmarketableEquityInvestments" xlink:label="hstm_ProceedsFromTheSaleOfNonmarketableEquityInvestments" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" xlink:label="us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_AmortizationOfDeferredSalesCommissions" xlink:label="us-gaap_AmortizationOfDeferredSalesCommissions" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_CapitalExpendituresIncurredButNotYetPaid" xlink:label="us-gaap_CapitalExpendituresIncurredButNotYetPaid" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsIncludingDisposalGroupAndDiscontinuedOperations" xlink:label="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsIncludingDisposalGroupAndDiscontinuedOperations-4" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsIncludingDisposalGroupAndDiscontinuedOperations" xlink:label="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsIncludingDisposalGroupAndDiscontinuedOperations-5" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsPeriodIncreaseDecreaseIncludingExchangeRateEffect" xlink:label="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsPeriodIncreaseDecreaseIncludingExchangeRateEffect-3" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DeferredIncomeTaxExpenseBenefit" xlink:label="us-gaap_DeferredIncomeTaxExpenseBenefit" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DepreciationDepletionAndAmortization" xlink:label="us-gaap_DepreciationDepletionAndAmortization-1" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_EffectOfExchangeRateOnCashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents" xlink:label="us-gaap_EffectOfExchangeRateOnCashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_GainLossOnDispositionOfAssets" xlink:label="us-gaap_GainLossOnDispositionOfAssets-n8" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_IncomeLossFromEquityMethodInvestments" xlink:label="us-gaap_IncomeLossFromEquityMethodInvestments-n8" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_IncomeTaxesPaidNet" xlink:label="us-gaap_IncomeTaxesPaidNet" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_IncreaseDecreaseInAccountsPayableAndAccruedLiabilities" xlink:label="us-gaap_IncreaseDecreaseInAccountsPayableAndAccruedLiabilities-1" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_IncreaseDecreaseInContractWithCustomerLiability" xlink:label="us-gaap_IncreaseDecreaseInContractWithCustomerLiability-1" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_IncreaseDecreaseInOperatingCapitalAbstract" xlink:label="us-gaap_IncreaseDecreaseInOperatingCapitalAbstract" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_IncreaseDecreaseInOtherOperatingAssets" xlink:label="us-gaap_IncreaseDecreaseInOtherOperatingAssets-n8" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_IncreaseDecreaseInPrepaidDeferredExpenseAndOtherAssets" xlink:label="us-gaap_IncreaseDecreaseInPrepaidDeferredExpenseAndOtherAssets-n8" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_IncreaseDecreaseInPrepaidRoyalties" xlink:label="us-gaap_IncreaseDecreaseInPrepaidRoyalties-n8" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_IncreaseDecreaseInReceivables" xlink:label="us-gaap_IncreaseDecreaseInReceivables-n1" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_IncreaseDecreaseInRoyaltiesPayable" xlink:label="us-gaap_IncreaseDecreaseInRoyaltiesPayable-1" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_InterestPaidNet" xlink:label="us-gaap_InterestPaidNet" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_NetCashProvidedByUsedInFinancingActivities" xlink:label="us-gaap_NetCashProvidedByUsedInFinancingActivities-3" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_NetCashProvidedByUsedInFinancingActivitiesAbstract" xlink:label="us-gaap_NetCashProvidedByUsedInFinancingActivitiesAbstract" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_NetCashProvidedByUsedInInvestingActivities" xlink:label="us-gaap_NetCashProvidedByUsedInInvestingActivities-3" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_NetCashProvidedByUsedInInvestingActivitiesAbstract" xlink:label="us-gaap_NetCashProvidedByUsedInInvestingActivitiesAbstract" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_NetCashProvidedByUsedInOperatingActivities" xlink:label="us-gaap_NetCashProvidedByUsedInOperatingActivities-3" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_NetCashProvidedByUsedInOperatingActivitiesAbstract" xlink:label="us-gaap_NetCashProvidedByUsedInOperatingActivitiesAbstract" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_NetIncomeLoss" xlink:label="us-gaap_NetIncomeLoss-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_NoncashInvestingAndFinancingItemsAbstract" xlink:label="us-gaap_NoncashInvestingAndFinancingItemsAbstract" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_OtherNoncashIncomeExpense" xlink:label="us-gaap_OtherNoncashIncomeExpense-n8" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_PaymentsForRepurchaseOfCommonStock" xlink:label="us-gaap_PaymentsForRepurchaseOfCommonStock-n8" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_PaymentsForSoftware" xlink:label="us-gaap_PaymentsForSoftware-n8" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_PaymentsOfDividendsCommonStock" xlink:label="us-gaap_PaymentsOfDividendsCommonStock-n8" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_PaymentsRelatedToTaxWithholdingForShareBasedCompensation" xlink:label="us-gaap_PaymentsRelatedToTaxWithholdingForShareBasedCompensation-n8" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_PaymentsToAcquireBusinessesNetOfCashAcquired" xlink:label="us-gaap_PaymentsToAcquireBusinessesNetOfCashAcquired-n8" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_PaymentsToAcquireMarketableSecurities" xlink:label="us-gaap_PaymentsToAcquireMarketableSecurities-n8" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_PaymentsToAcquirePropertyPlantAndEquipment" xlink:label="us-gaap_PaymentsToAcquirePropertyPlantAndEquipment-n8" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ProceedsFromMaturitiesPrepaymentsAndCallsOfAvailableForSaleSecurities" xlink:label="us-gaap_ProceedsFromMaturitiesPrepaymentsAndCallsOfAvailableForSaleSecurities" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ProceedsFromSaleOfPropertyPlantAndEquipment" xlink:label="us-gaap_ProceedsFromSaleOfPropertyPlantAndEquipment" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ProvisionForDoubtfulAccounts" xlink:label="us-gaap_ProvisionForDoubtfulAccounts" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ShareBasedCompensation" xlink:label="us-gaap_ShareBasedCompensation-1" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementOfCashFlowsAbstract" xlink:label="us-gaap_StatementOfCashFlowsAbstract" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StockIssued1" xlink:label="us-gaap_StockIssued1" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_SupplementalCashFlowInformationAbstract" xlink:label="us-gaap_SupplementalCashFlowInformationAbstract" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementOfCashFlowsAbstract" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_NetCashProvidedByUsedInOperatingActivitiesAbstract" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="us-gaap_NetIncomeLoss-2" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="us-gaap_DepreciationDepletionAndAmortization-1" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="us-gaap_ShareBasedCompensation-1" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="us-gaap_AmortizationOfDeferredSalesCommissions" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="us-gaap_ProvisionForDoubtfulAccounts" xlink:type="arc"/>
    <link:presentationArc order="4" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="us-gaap_DeferredIncomeTaxExpenseBenefit" xlink:type="arc"/>
    <link:presentationArc order="5" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="us-gaap_GainLossOnDispositionOfAssets-n8" xlink:type="arc"/>
    <link:presentationArc order="6" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="us-gaap_IncomeLossFromEquityMethodInvestments-n8" xlink:type="arc"/>
    <link:presentationArc order="7" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="hstm_ChangeInFairValueOfNonMarketableEquityInvestments" xlink:type="arc"/>
    <link:presentationArc order="8" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="us-gaap_OtherNoncashIncomeExpense-n8" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_IncreaseDecreaseInOperatingCapitalAbstract" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncreaseDecreaseInOperatingCapitalAbstract" xlink:to="us-gaap_IncreaseDecreaseInReceivables-n1" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncreaseDecreaseInOperatingCapitalAbstract" xlink:to="us-gaap_IncreaseDecreaseInPrepaidRoyalties-n8" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncreaseDecreaseInOperatingCapitalAbstract" xlink:to="us-gaap_IncreaseDecreaseInPrepaidDeferredExpenseAndOtherAssets-n8" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncreaseDecreaseInOperatingCapitalAbstract" xlink:to="hstm_IncreaseDecreaseInDeferredCommissions-n8" xlink:type="arc"/>
    <link:presentationArc order="4" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncreaseDecreaseInOperatingCapitalAbstract" xlink:to="us-gaap_IncreaseDecreaseInOtherOperatingAssets-n8" xlink:type="arc"/>
    <link:presentationArc order="5" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncreaseDecreaseInOperatingCapitalAbstract" xlink:to="us-gaap_IncreaseDecreaseInAccountsPayableAndAccruedLiabilities-1" xlink:type="arc"/>
    <link:presentationArc order="6" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncreaseDecreaseInOperatingCapitalAbstract" xlink:to="us-gaap_IncreaseDecreaseInRoyaltiesPayable-1" xlink:type="arc"/>
    <link:presentationArc order="7" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncreaseDecreaseInOperatingCapitalAbstract" xlink:to="us-gaap_IncreaseDecreaseInContractWithCustomerLiability-1" xlink:type="arc"/>
    <link:presentationArc order="8" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncreaseDecreaseInOperatingCapitalAbstract" xlink:to="us-gaap_NetCashProvidedByUsedInOperatingActivities-3" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_NetCashProvidedByUsedInInvestingActivitiesAbstract" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInInvestingActivitiesAbstract" xlink:to="us-gaap_PaymentsToAcquireBusinessesNetOfCashAcquired-n8" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInInvestingActivitiesAbstract" xlink:to="us-gaap_ProceedsFromMaturitiesPrepaymentsAndCallsOfAvailableForSaleSecurities" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInInvestingActivitiesAbstract" xlink:to="us-gaap_PaymentsToAcquireMarketableSecurities-n8" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInInvestingActivitiesAbstract" xlink:to="us-gaap_ProceedsFromSaleOfPropertyPlantAndEquipment" xlink:type="arc"/>
    <link:presentationArc order="4" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInInvestingActivitiesAbstract" xlink:to="hstm_ProceedsFromTheSaleOfNonmarketableEquityInvestments" xlink:type="arc"/>
    <link:presentationArc order="5" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInInvestingActivitiesAbstract" xlink:to="us-gaap_PaymentsForSoftware-n8" xlink:type="arc"/>
    <link:presentationArc order="6" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInInvestingActivitiesAbstract" xlink:to="us-gaap_PaymentsToAcquirePropertyPlantAndEquipment-n8" xlink:type="arc"/>
    <link:presentationArc order="7" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInInvestingActivitiesAbstract" xlink:to="us-gaap_NetCashProvidedByUsedInInvestingActivities-3" xlink:type="arc"/>
    <link:presentationArc order="4" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_NetCashProvidedByUsedInFinancingActivitiesAbstract" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInFinancingActivitiesAbstract" xlink:to="us-gaap_PaymentsRelatedToTaxWithholdingForShareBasedCompensation-n8" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInFinancingActivitiesAbstract" xlink:to="hstm_PaymentsForDebtIssueCosts-n8" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInFinancingActivitiesAbstract" xlink:to="us-gaap_PaymentsForRepurchaseOfCommonStock-n8" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInFinancingActivitiesAbstract" xlink:to="us-gaap_PaymentsOfDividendsCommonStock-n8" xlink:type="arc"/>
    <link:presentationArc order="4" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInFinancingActivitiesAbstract" xlink:to="us-gaap_NetCashProvidedByUsedInFinancingActivities-3" xlink:type="arc"/>
    <link:presentationArc order="5" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInFinancingActivitiesAbstract" xlink:to="us-gaap_EffectOfExchangeRateOnCashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents" xlink:type="arc"/>
    <link:presentationArc order="6" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInFinancingActivitiesAbstract" xlink:to="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsPeriodIncreaseDecreaseIncludingExchangeRateEffect-3" xlink:type="arc"/>
    <link:presentationArc order="7" preferredLabel="http://www.xbrl.org/2003/role/periodStartLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInFinancingActivitiesAbstract" xlink:to="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsIncludingDisposalGroupAndDiscontinuedOperations-4" xlink:type="arc"/>
    <link:presentationArc order="8" preferredLabel="http://www.xbrl.org/2003/role/periodEndLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInFinancingActivitiesAbstract" xlink:to="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsIncludingDisposalGroupAndDiscontinuedOperations-5" xlink:type="arc"/>
    <link:presentationArc order="5" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_SupplementalCashFlowInformationAbstract" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_SupplementalCashFlowInformationAbstract" xlink:to="us-gaap_InterestPaidNet" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_SupplementalCashFlowInformationAbstract" xlink:to="us-gaap_IncomeTaxesPaidNet" xlink:type="arc"/>
    <link:presentationArc order="6" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_NoncashInvestingAndFinancingItemsAbstract" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NoncashInvestingAndFinancingItemsAbstract" xlink:to="us-gaap_CapitalExpendituresIncurredButNotYetPaid" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NoncashInvestingAndFinancingItemsAbstract" xlink:to="hstm_CapitalizedSoftwareDevelopmentExpendituresIncurredButNotYetPaid" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NoncashInvestingAndFinancingItemsAbstract" xlink:to="us-gaap_StockIssued1" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-note-9-income-taxes-significant-components-of-deferred-tax-assets-and-deferred-tax-liabilities-details" xlink:href="hstm-20241231.xsd#statement-note-9-income-taxes-significant-components-of-deferred-tax-assets-and-deferred-tax-liabilities-details" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-note-9-income-taxes-significant-components-of-deferred-tax-assets-and-deferred-tax-liabilities-details" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_DeferredTaxAssetsCapitalizedSoftwareDevelopment" xlink:label="hstm_DeferredTaxAssetsCapitalizedSoftwareDevelopment-1" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_DeferredTaxAssetsTaxLeaseLiability" xlink:label="hstm_DeferredTaxAssetsTaxLeaseLiability" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_statement-statement-note-9-income-taxes-significant-components-of-deferred-tax-assets-and-deferred-tax-liabilities-details" xlink:label="hstm_statement-statement-note-9-income-taxes-significant-components-of-deferred-tax-assets-and-deferred-tax-liabilities-details" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DeferredIncomeTaxLiabilities" xlink:label="us-gaap_DeferredIncomeTaxLiabilities-3" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DeferredTaxAssetsDeferredIncome" xlink:label="us-gaap_DeferredTaxAssetsDeferredIncome-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DeferredTaxAssetsGross" xlink:label="us-gaap_DeferredTaxAssetsGross-3" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DeferredTaxAssetsNet" xlink:label="us-gaap_DeferredTaxAssetsNet-3" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DeferredTaxAssetsNetAbstract" xlink:label="us-gaap_DeferredTaxAssetsNetAbstract" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DeferredTaxAssetsOperatingLossCarryforwards" xlink:label="us-gaap_DeferredTaxAssetsOperatingLossCarryforwards" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DeferredTaxAssetsTaxCreditCarryforwards" xlink:label="us-gaap_DeferredTaxAssetsTaxCreditCarryforwards" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DeferredTaxAssetsTaxDeferredExpenseCompensationAndBenefitsShareBasedCompensationCost" xlink:label="us-gaap_DeferredTaxAssetsTaxDeferredExpenseCompensationAndBenefitsShareBasedCompensationCost-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAccruedLiabilities" xlink:label="us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAccruedLiabilities-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts" xlink:label="us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DeferredTaxAssetsValuationAllowance" xlink:label="us-gaap_DeferredTaxAssetsValuationAllowance-n8" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DeferredTaxLiabilities" xlink:label="us-gaap_DeferredTaxLiabilities-3" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DeferredTaxLiabilitiesDeferredExpenseCapitalizedSoftware" xlink:label="us-gaap_DeferredTaxLiabilitiesDeferredExpenseCapitalizedSoftware" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DeferredTaxLiabilitiesGoodwillAndIntangibleAssetsGoodwill" xlink:label="us-gaap_DeferredTaxLiabilitiesGoodwillAndIntangibleAssetsGoodwill" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DeferredTaxLiabilitiesGoodwillAndIntangibleAssetsIntangibleAssets" xlink:label="us-gaap_DeferredTaxLiabilitiesGoodwillAndIntangibleAssetsIntangibleAssets" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DeferredTaxLiabilitiesInvestments" xlink:label="us-gaap_DeferredTaxLiabilitiesInvestments-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DeferredTaxLiabilitiesLeasingArrangements" xlink:label="us-gaap_DeferredTaxLiabilitiesLeasingArrangements" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DeferredTaxLiabilitiesNetAbstract" xlink:label="us-gaap_DeferredTaxLiabilitiesNetAbstract" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DeferredTaxLiabilitiesPrepaidExpenses" xlink:label="us-gaap_DeferredTaxLiabilitiesPrepaidExpenses-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DeferredTaxLiabilitiesPropertyPlantAndEquipment" xlink:label="us-gaap_DeferredTaxLiabilitiesPropertyPlantAndEquipment" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_statement-statement-note-9-income-taxes-significant-components-of-deferred-tax-assets-and-deferred-tax-liabilities-details" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_DeferredTaxAssetsNetAbstract" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DeferredTaxAssetsNetAbstract" xlink:to="us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DeferredTaxAssetsNetAbstract" xlink:to="us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAccruedLiabilities-2" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DeferredTaxAssetsNetAbstract" xlink:to="hstm_DeferredTaxAssetsCapitalizedSoftwareDevelopment-1" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DeferredTaxAssetsNetAbstract" xlink:to="hstm_DeferredTaxAssetsTaxLeaseLiability" xlink:type="arc"/>
    <link:presentationArc order="4" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DeferredTaxAssetsNetAbstract" xlink:to="us-gaap_DeferredTaxAssetsTaxCreditCarryforwards" xlink:type="arc"/>
    <link:presentationArc order="5" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DeferredTaxAssetsNetAbstract" xlink:to="us-gaap_DeferredTaxAssetsTaxDeferredExpenseCompensationAndBenefitsShareBasedCompensationCost-2" xlink:type="arc"/>
    <link:presentationArc order="6" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DeferredTaxAssetsNetAbstract" xlink:to="us-gaap_DeferredTaxAssetsDeferredIncome-2" xlink:type="arc"/>
    <link:presentationArc order="7" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DeferredTaxAssetsNetAbstract" xlink:to="us-gaap_DeferredTaxAssetsOperatingLossCarryforwards" xlink:type="arc"/>
    <link:presentationArc order="8" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DeferredTaxAssetsNetAbstract" xlink:to="us-gaap_DeferredTaxAssetsGross-3" xlink:type="arc"/>
    <link:presentationArc order="9" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DeferredTaxAssetsNetAbstract" xlink:to="us-gaap_DeferredTaxAssetsValuationAllowance-n8" xlink:type="arc"/>
    <link:presentationArc order="10" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DeferredTaxAssetsNetAbstract" xlink:to="us-gaap_DeferredTaxAssetsNet-3" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_DeferredTaxLiabilitiesNetAbstract" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DeferredTaxLiabilitiesNetAbstract" xlink:to="us-gaap_DeferredTaxLiabilitiesGoodwillAndIntangibleAssetsGoodwill" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DeferredTaxLiabilitiesNetAbstract" xlink:to="us-gaap_DeferredTaxLiabilitiesGoodwillAndIntangibleAssetsIntangibleAssets" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DeferredTaxLiabilitiesNetAbstract" xlink:to="us-gaap_DeferredTaxLiabilitiesLeasingArrangements" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DeferredTaxLiabilitiesNetAbstract" xlink:to="us-gaap_DeferredTaxLiabilitiesPrepaidExpenses-2" xlink:type="arc"/>
    <link:presentationArc order="4" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DeferredTaxLiabilitiesNetAbstract" xlink:to="us-gaap_DeferredTaxLiabilitiesDeferredExpenseCapitalizedSoftware" xlink:type="arc"/>
    <link:presentationArc order="5" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DeferredTaxLiabilitiesNetAbstract" xlink:to="us-gaap_DeferredTaxLiabilitiesPropertyPlantAndEquipment" xlink:type="arc"/>
    <link:presentationArc order="6" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DeferredTaxLiabilitiesNetAbstract" xlink:to="us-gaap_DeferredTaxLiabilitiesInvestments-2" xlink:type="arc"/>
    <link:presentationArc order="7" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DeferredTaxLiabilitiesNetAbstract" xlink:to="us-gaap_DeferredIncomeTaxLiabilities-3" xlink:type="arc"/>
    <link:presentationArc order="8" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DeferredTaxLiabilitiesNetAbstract" xlink:to="us-gaap_DeferredTaxLiabilities-3" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-consolidated-statements-of-income" xlink:href="hstm-20241231.xsd#statement-consolidated-statements-of-income" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-consolidated-statements-of-income" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_CommonStockDividendsPerShareDeclared" xlink:label="us-gaap_CommonStockDividendsPerShareDeclared-1" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_CostOfGoodsAndServiceExcludingDepreciationDepletionAndAmortization" xlink:label="us-gaap_CostOfGoodsAndServiceExcludingDepreciationDepletionAndAmortization" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_CostsAndExpenses" xlink:label="us-gaap_CostsAndExpenses-3" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_CostsAndExpensesAbstract" xlink:label="us-gaap_CostsAndExpensesAbstract" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DepreciationDepletionAndAmortization" xlink:label="us-gaap_DepreciationDepletionAndAmortization-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_EarningsPerShareAbstract" xlink:label="us-gaap_EarningsPerShareAbstract" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_EarningsPerShareBasic" xlink:label="us-gaap_EarningsPerShareBasic" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_EarningsPerShareDiluted" xlink:label="us-gaap_EarningsPerShareDiluted" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest" xlink:label="us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest-3" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_IncomeStatementAbstract" xlink:label="us-gaap_IncomeStatementAbstract" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_IncomeTaxExpenseBenefit" xlink:label="us-gaap_IncomeTaxExpenseBenefit" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_InvestmentIncomeNonoperating" xlink:label="us-gaap_InvestmentIncomeNonoperating" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_NetIncomeLoss" xlink:label="us-gaap_NetIncomeLoss-3" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_OperatingIncomeLoss" xlink:label="us-gaap_OperatingIncomeLoss-3" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_OtherGeneralAndAdministrativeExpense" xlink:label="us-gaap_OtherGeneralAndAdministrativeExpense" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_OtherNonoperatingIncomeExpense" xlink:label="us-gaap_OtherNonoperatingIncomeExpense" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ResearchAndDevelopmentExpense" xlink:label="us-gaap_ResearchAndDevelopmentExpense" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_RevenueFromContractWithCustomerExcludingAssessedTax" xlink:label="us-gaap_RevenueFromContractWithCustomerExcludingAssessedTax" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_SellingAndMarketingExpense" xlink:label="us-gaap_SellingAndMarketingExpense" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_WeightedAverageNumberOfDilutedSharesOutstanding" xlink:label="us-gaap_WeightedAverageNumberOfDilutedSharesOutstanding" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_WeightedAverageNumberOfSharesOutstandingAbstract" xlink:label="us-gaap_WeightedAverageNumberOfSharesOutstandingAbstract" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_WeightedAverageNumberOfSharesOutstandingBasic" xlink:label="us-gaap_WeightedAverageNumberOfSharesOutstandingBasic" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeStatementAbstract" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_RevenueFromContractWithCustomerExcludingAssessedTax" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_CostsAndExpensesAbstract" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CostsAndExpensesAbstract" xlink:to="us-gaap_CostOfGoodsAndServiceExcludingDepreciationDepletionAndAmortization" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CostsAndExpensesAbstract" xlink:to="us-gaap_ResearchAndDevelopmentExpense" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CostsAndExpensesAbstract" xlink:to="us-gaap_SellingAndMarketingExpense" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CostsAndExpensesAbstract" xlink:to="us-gaap_OtherGeneralAndAdministrativeExpense" xlink:type="arc"/>
    <link:presentationArc order="4" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CostsAndExpensesAbstract" xlink:to="us-gaap_DepreciationDepletionAndAmortization-2" xlink:type="arc"/>
    <link:presentationArc order="5" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CostsAndExpensesAbstract" xlink:to="us-gaap_CostsAndExpenses-3" xlink:type="arc"/>
    <link:presentationArc order="6" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CostsAndExpensesAbstract" xlink:to="us-gaap_OperatingIncomeLoss-3" xlink:type="arc"/>
    <link:presentationArc order="7" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CostsAndExpensesAbstract" xlink:to="us-gaap_InvestmentIncomeNonoperating" xlink:type="arc"/>
    <link:presentationArc order="8" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CostsAndExpensesAbstract" xlink:to="us-gaap_OtherNonoperatingIncomeExpense" xlink:type="arc"/>
    <link:presentationArc order="9" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CostsAndExpensesAbstract" xlink:to="us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest-3" xlink:type="arc"/>
    <link:presentationArc order="10" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CostsAndExpensesAbstract" xlink:to="us-gaap_IncomeTaxExpenseBenefit" xlink:type="arc"/>
    <link:presentationArc order="11" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CostsAndExpensesAbstract" xlink:to="us-gaap_NetIncomeLoss-3" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_EarningsPerShareAbstract" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EarningsPerShareAbstract" xlink:to="us-gaap_EarningsPerShareBasic" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EarningsPerShareAbstract" xlink:to="us-gaap_EarningsPerShareDiluted" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_WeightedAverageNumberOfSharesOutstandingAbstract" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_WeightedAverageNumberOfSharesOutstandingAbstract" xlink:to="us-gaap_WeightedAverageNumberOfSharesOutstandingBasic" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_WeightedAverageNumberOfSharesOutstandingAbstract" xlink:to="us-gaap_WeightedAverageNumberOfDilutedSharesOutstanding" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_WeightedAverageNumberOfSharesOutstandingAbstract" xlink:to="us-gaap_CommonStockDividendsPerShareDeclared-1" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-consolidated-statements-of-comprehensive-income" xlink:href="hstm-20241231.xsd#statement-consolidated-statements-of-comprehensive-income" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-consolidated-statements-of-comprehensive-income" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ComprehensiveIncomeNetOfTax" xlink:label="us-gaap_ComprehensiveIncomeNetOfTax-3" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_NetIncomeLoss" xlink:label="us-gaap_NetIncomeLoss" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_OtherComprehensiveIncomeForeignCurrencyTransactionAndTranslationAdjustmentNetOfTaxPortionAttributableToParent" xlink:label="us-gaap_OtherComprehensiveIncomeForeignCurrencyTransactionAndTranslationAdjustmentNetOfTaxPortionAttributableToParent" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_OtherComprehensiveIncomeLossNetOfTaxPortionAttributableToParent" xlink:label="us-gaap_OtherComprehensiveIncomeLossNetOfTaxPortionAttributableToParent-3" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_OtherComprehensiveIncomeLossNetOfTaxPortionAttributableToParentAbstract" xlink:label="us-gaap_OtherComprehensiveIncomeLossNetOfTaxPortionAttributableToParentAbstract" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_OtherComprehensiveIncomeUnrealizedHoldingGainLossOnSecuritiesArisingDuringPeriodNetOfTax" xlink:label="us-gaap_OtherComprehensiveIncomeUnrealizedHoldingGainLossOnSecuritiesArisingDuringPeriodNetOfTax" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementOfIncomeAndComprehensiveIncomeAbstract" xlink:label="us-gaap_StatementOfIncomeAndComprehensiveIncomeAbstract" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementOfIncomeAndComprehensiveIncomeAbstract" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_NetIncomeLoss" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_OtherComprehensiveIncomeLossNetOfTaxPortionAttributableToParentAbstract" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_OtherComprehensiveIncomeLossNetOfTaxPortionAttributableToParentAbstract" xlink:to="us-gaap_OtherComprehensiveIncomeForeignCurrencyTransactionAndTranslationAdjustmentNetOfTaxPortionAttributableToParent" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_OtherComprehensiveIncomeLossNetOfTaxPortionAttributableToParentAbstract" xlink:to="us-gaap_OtherComprehensiveIncomeUnrealizedHoldingGainLossOnSecuritiesArisingDuringPeriodNetOfTax" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_OtherComprehensiveIncomeLossNetOfTaxPortionAttributableToParentAbstract" xlink:to="us-gaap_OtherComprehensiveIncomeLossNetOfTaxPortionAttributableToParent-3" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_OtherComprehensiveIncomeLossNetOfTaxPortionAttributableToParentAbstract" xlink:to="us-gaap_ComprehensiveIncomeNetOfTax-3" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-consolidated-statements-of-shareholders-equity" xlink:href="hstm-20241231.xsd#statement-consolidated-statements-of-shareholders-equity" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-consolidated-statements-of-shareholders-equity" xlink:type="extended">
    <link:loc xlink:href="hstm-20241231.xsd#hstm_ExciseTaxOnCommonStockRepurchased" xlink:label="hstm_ExciseTaxOnCommonStockRepurchased" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_AccumulatedOtherComprehensiveIncomeMember" xlink:label="us-gaap_AccumulatedOtherComprehensiveIncomeMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue" xlink:label="us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_CommonStockIncludingAdditionalPaidInCapitalMember" xlink:label="us-gaap_CommonStockIncludingAdditionalPaidInCapitalMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_CommonStockSharesOutstanding" xlink:label="us-gaap_CommonStockSharesOutstanding-4" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_CommonStockSharesOutstanding" xlink:label="us-gaap_CommonStockSharesOutstanding-5" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DividendsCommonStock" xlink:label="us-gaap_DividendsCommonStock-n8" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_EquityComponentDomain" xlink:label="us-gaap_EquityComponentDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_NetIncomeLoss" xlink:label="us-gaap_NetIncomeLoss" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_OtherComprehensiveIncomeLossNetOfTaxPortionAttributableToParent" xlink:label="us-gaap_OtherComprehensiveIncomeLossNetOfTaxPortionAttributableToParent" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_RetainedEarningsMember" xlink:label="us-gaap_RetainedEarningsMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementEquityComponentsAxis" xlink:label="us-gaap_StatementEquityComponentsAxis" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementOfStockholdersEquityAbstract" xlink:label="us-gaap_StatementOfStockholdersEquityAbstract" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StockIssuedDuringPeriodSharesAcquisitions" xlink:label="us-gaap_StockIssuedDuringPeriodSharesAcquisitions" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensation" xlink:label="us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensation" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StockIssuedDuringPeriodValueAcquisitions" xlink:label="us-gaap_StockIssuedDuringPeriodValueAcquisitions" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StockIssuedDuringPeriodValueShareBasedCompensation" xlink:label="us-gaap_StockIssuedDuringPeriodValueShareBasedCompensation-n8" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StockRepurchasedDuringPeriodShares" xlink:label="us-gaap_StockRepurchasedDuringPeriodShares-n8" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StockRepurchasedDuringPeriodValue" xlink:label="us-gaap_StockRepurchasedDuringPeriodValue-n8" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StockholdersEquity" xlink:label="us-gaap_StockholdersEquity-4" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StockholdersEquity" xlink:label="us-gaap_StockholdersEquity-5" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementOfStockholdersEquityAbstract" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementEquityComponentsAxis" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementEquityComponentsAxis" xlink:to="us-gaap_CommonStockIncludingAdditionalPaidInCapitalMember" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementEquityComponentsAxis" xlink:to="us-gaap_RetainedEarningsMember" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementEquityComponentsAxis" xlink:to="us-gaap_AccumulatedOtherComprehensiveIncomeMember" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementEquityComponentsAxis" xlink:to="us-gaap_EquityComponentDomain" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/periodStartLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_CommonStockSharesOutstanding-4" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/periodStartLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_StockholdersEquity-4" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_NetIncomeLoss" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_OtherComprehensiveIncomeLossNetOfTaxPortionAttributableToParent" xlink:type="arc"/>
    <link:presentationArc order="4" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_StockIssuedDuringPeriodSharesAcquisitions" xlink:type="arc"/>
    <link:presentationArc order="5" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_StockIssuedDuringPeriodValueAcquisitions" xlink:type="arc"/>
    <link:presentationArc order="6" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue" xlink:type="arc"/>
    <link:presentationArc order="7" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensation" xlink:type="arc"/>
    <link:presentationArc order="8" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_StockIssuedDuringPeriodValueShareBasedCompensation-n8" xlink:type="arc"/>
    <link:presentationArc order="9" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_StockRepurchasedDuringPeriodShares-n8" xlink:type="arc"/>
    <link:presentationArc order="10" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_StockRepurchasedDuringPeriodValue-n8" xlink:type="arc"/>
    <link:presentationArc order="11" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_DividendsCommonStock-n8" xlink:type="arc"/>
    <link:presentationArc order="12" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="hstm_ExciseTaxOnCommonStockRepurchased" xlink:type="arc"/>
    <link:presentationArc order="13" preferredLabel="http://www.xbrl.org/2003/role/periodEndLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_CommonStockSharesOutstanding-5" xlink:type="arc"/>
    <link:presentationArc order="14" preferredLabel="http://www.xbrl.org/2003/role/periodEndLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_StockholdersEquity-5" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-note-5-revenue-recognition-revenues-disaggregated-by-revenue-source-details" xlink:href="hstm-20241231.xsd#statement-note-5-revenue-recognition-revenues-disaggregated-by-revenue-source-details" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-note-5-revenue-recognition-revenues-disaggregated-by-revenue-source-details" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_ProfessionalServicesMember" xlink:label="hstm_ProfessionalServicesMember" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_SubscriptionServicesMember" xlink:label="hstm_SubscriptionServicesMember" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_statement-statement-note-5-revenue-recognition-revenues-disaggregated-by-revenue-source-details" xlink:label="hstm_statement-statement-note-5-revenue-recognition-revenues-disaggregated-by-revenue-source-details" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/srt/2024/elts/srt-2024.xsd#srt_ProductOrServiceAxis" xlink:label="srt_ProductOrServiceAxis" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/srt/2024/elts/srt-2024.xsd#srt_ProductsAndServicesDomain" xlink:label="srt_ProductsAndServicesDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_RevenueFromContractWithCustomerExcludingAssessedTax" xlink:label="us-gaap_RevenueFromContractWithCustomerExcludingAssessedTax-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_statement-statement-note-5-revenue-recognition-revenues-disaggregated-by-revenue-source-details" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ProductOrServiceAxis" xlink:to="srt_ProductsAndServicesDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="srt_ProductOrServiceAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ProductOrServiceAxis" xlink:to="hstm_SubscriptionServicesMember" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ProductOrServiceAxis" xlink:to="hstm_ProfessionalServicesMember" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_RevenueFromContractWithCustomerExcludingAssessedTax-2" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-note-6-property-and-equipment-summary-of-property-and-equipment-details" xlink:href="hstm-20241231.xsd#statement-note-6-property-and-equipment-summary-of-property-and-equipment-details" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-note-6-property-and-equipment-summary-of-property-and-equipment-details" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_statement-statement-note-6-property-and-equipment-summary-of-property-and-equipment-details" xlink:label="hstm_statement-statement-note-6-property-and-equipment-summary-of-property-and-equipment-details" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment" xlink:label="us-gaap_AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment-n8" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_EquipmentMember" xlink:label="us-gaap_EquipmentMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_FurnitureAndFixturesMember" xlink:label="us-gaap_FurnitureAndFixturesMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_LeaseholdImprovementsMember" xlink:label="us-gaap_LeaseholdImprovementsMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_PropertyPlantAndEquipmentByTypeAxis" xlink:label="us-gaap_PropertyPlantAndEquipmentByTypeAxis" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_PropertyPlantAndEquipmentGross" xlink:label="us-gaap_PropertyPlantAndEquipmentGross" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_PropertyPlantAndEquipmentNet" xlink:label="us-gaap_PropertyPlantAndEquipmentNet-3" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_PropertyPlantAndEquipmentTypeDomain" xlink:label="us-gaap_PropertyPlantAndEquipmentTypeDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_statement-statement-note-6-property-and-equipment-summary-of-property-and-equipment-details" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PropertyPlantAndEquipmentByTypeAxis" xlink:to="us-gaap_PropertyPlantAndEquipmentTypeDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_PropertyPlantAndEquipmentByTypeAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PropertyPlantAndEquipmentByTypeAxis" xlink:to="us-gaap_EquipmentMember" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PropertyPlantAndEquipmentByTypeAxis" xlink:to="us-gaap_LeaseholdImprovementsMember" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PropertyPlantAndEquipmentByTypeAxis" xlink:to="us-gaap_FurnitureAndFixturesMember" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_PropertyPlantAndEquipmentGross" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment-n8" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_PropertyPlantAndEquipmentNet-3" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-note-7-goodwill-and-intangible-assets-identifiable-intangible-assets-details" xlink:href="hstm-20241231.xsd#statement-note-7-goodwill-and-intangible-assets-identifiable-intangible-assets-details" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-note-7-goodwill-and-intangible-assets-identifiable-intangible-assets-details" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_statement-statement-note-7-goodwill-and-intangible-assets-identifiable-intangible-assets-details" xlink:label="hstm_statement-statement-note-7-goodwill-and-intangible-assets-identifiable-intangible-assets-details" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_CustomerRelationshipsMember" xlink:label="us-gaap_CustomerRelationshipsMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_FiniteLivedIntangibleAssetsAccumulatedAmortization" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAccumulatedAmortization-n8" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis" xlink:label="us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain" xlink:label="us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_IntangibleAssetsGrossExcludingGoodwill" xlink:label="us-gaap_IntangibleAssetsGrossExcludingGoodwill" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_IntangibleAssetsNetExcludingGoodwill" xlink:label="us-gaap_IntangibleAssetsNetExcludingGoodwill" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_OtherIntangibleAssetsMember" xlink:label="us-gaap_OtherIntangibleAssetsMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_statement-statement-note-7-goodwill-and-intangible-assets-identifiable-intangible-assets-details" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis" xlink:to="us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis" xlink:to="us-gaap_CustomerRelationshipsMember" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis" xlink:to="us-gaap_OtherIntangibleAssetsMember" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_IntangibleAssetsGrossExcludingGoodwill" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_FiniteLivedIntangibleAssetsAccumulatedAmortization-n8" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_IntangibleAssetsNetExcludingGoodwill" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-note-9-income-taxes-schedule-of-components-of-earnings-before-income-taxes-details" xlink:href="hstm-20241231.xsd#statement-note-9-income-taxes-schedule-of-components-of-earnings-before-income-taxes-details" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-note-9-income-taxes-schedule-of-components-of-earnings-before-income-taxes-details" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_statement-statement-note-9-income-taxes-schedule-of-components-of-earnings-before-income-taxes-details" xlink:label="hstm_statement-statement-note-9-income-taxes-schedule-of-components-of-earnings-before-income-taxes-details" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesDomestic" xlink:label="us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesDomestic" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesForeign" xlink:label="us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesForeign" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesMinorityInterestAndIncomeLossFromEquityMethodInvestments" xlink:label="us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesMinorityInterestAndIncomeLossFromEquityMethodInvestments-3" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_statement-statement-note-9-income-taxes-schedule-of-components-of-earnings-before-income-taxes-details" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesDomestic" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesForeign" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesMinorityInterestAndIncomeLossFromEquityMethodInvestments-3" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-note-9-income-taxes-summary-of-provision-for-income-taxes-details" xlink:href="hstm-20241231.xsd#statement-note-9-income-taxes-summary-of-provision-for-income-taxes-details" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-note-9-income-taxes-summary-of-provision-for-income-taxes-details" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_statement-statement-note-9-income-taxes-summary-of-provision-for-income-taxes-details" xlink:label="hstm_statement-statement-note-9-income-taxes-summary-of-provision-for-income-taxes-details" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_CurrentFederalTaxExpenseBenefit" xlink:label="us-gaap_CurrentFederalTaxExpenseBenefit" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_CurrentForeignTaxExpenseBenefit" xlink:label="us-gaap_CurrentForeignTaxExpenseBenefit" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_CurrentStateAndLocalTaxExpenseBenefit" xlink:label="us-gaap_CurrentStateAndLocalTaxExpenseBenefit" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DeferredFederalIncomeTaxExpenseBenefit" xlink:label="us-gaap_DeferredFederalIncomeTaxExpenseBenefit" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DeferredForeignIncomeTaxExpenseBenefit" xlink:label="us-gaap_DeferredForeignIncomeTaxExpenseBenefit" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_DeferredStateAndLocalIncomeTaxExpenseBenefit" xlink:label="us-gaap_DeferredStateAndLocalIncomeTaxExpenseBenefit" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_IncomeTaxExpenseBenefit" xlink:label="us-gaap_IncomeTaxExpenseBenefit-3" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_statement-statement-note-9-income-taxes-summary-of-provision-for-income-taxes-details" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_CurrentFederalTaxExpenseBenefit" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_CurrentStateAndLocalTaxExpenseBenefit" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_CurrentForeignTaxExpenseBenefit" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_DeferredFederalIncomeTaxExpenseBenefit" xlink:type="arc"/>
    <link:presentationArc order="4" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_DeferredStateAndLocalIncomeTaxExpenseBenefit" xlink:type="arc"/>
    <link:presentationArc order="5" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_DeferredForeignIncomeTaxExpenseBenefit" xlink:type="arc"/>
    <link:presentationArc order="6" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_IncomeTaxExpenseBenefit-3" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-note-9-income-taxes-reconciliation-of-income-taxes-at-the-statutory-federal-income-tax-rate-to-the-provision-for-income-taxes-details" xlink:href="hstm-20241231.xsd#statement-note-9-income-taxes-reconciliation-of-income-taxes-at-the-statutory-federal-income-tax-rate-to-the-provision-for-income-taxes-details" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-note-9-income-taxes-reconciliation-of-income-taxes-at-the-statutory-federal-income-tax-rate-to-the-provision-for-income-taxes-details" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_EffectiveIncomeTaxRateReconciliationChangeInUncertainTaxPositionsAmount" xlink:label="hstm_EffectiveIncomeTaxRateReconciliationChangeInUncertainTaxPositionsAmount" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_statement-statement-note-9-income-taxes-reconciliation-of-income-taxes-at-the-statutory-federal-income-tax-rate-to-the-provision-for-income-taxes-details" xlink:label="hstm_statement-statement-note-9-income-taxes-reconciliation-of-income-taxes-at-the-statutory-federal-income-tax-rate-to-the-provision-for-income-taxes-details" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_IncomeTaxExpenseBenefit" xlink:label="us-gaap_IncomeTaxExpenseBenefit-3" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_IncomeTaxReconciliationChangeInDeferredTaxAssetsValuationAllowance" xlink:label="us-gaap_IncomeTaxReconciliationChangeInDeferredTaxAssetsValuationAllowance" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_IncomeTaxReconciliationIncomeTaxExpenseBenefitAtFederalStatutoryIncomeTaxRate" xlink:label="us-gaap_IncomeTaxReconciliationIncomeTaxExpenseBenefitAtFederalStatutoryIncomeTaxRate" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_IncomeTaxReconciliationOtherAdjustments" xlink:label="us-gaap_IncomeTaxReconciliationOtherAdjustments" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_IncomeTaxReconciliationPriorYearIncomeTaxes" xlink:label="us-gaap_IncomeTaxReconciliationPriorYearIncomeTaxes" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_IncomeTaxReconciliationStateAndLocalIncomeTaxes" xlink:label="us-gaap_IncomeTaxReconciliationStateAndLocalIncomeTaxes" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_IncomeTaxReconciliationTaxCredits" xlink:label="us-gaap_IncomeTaxReconciliationTaxCredits-n8" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_statement-statement-note-9-income-taxes-reconciliation-of-income-taxes-at-the-statutory-federal-income-tax-rate-to-the-provision-for-income-taxes-details" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_IncomeTaxReconciliationIncomeTaxExpenseBenefitAtFederalStatutoryIncomeTaxRate" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_IncomeTaxReconciliationStateAndLocalIncomeTaxes" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_IncomeTaxReconciliationTaxCredits-n8" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_IncomeTaxReconciliationChangeInDeferredTaxAssetsValuationAllowance" xlink:type="arc"/>
    <link:presentationArc order="4" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_IncomeTaxReconciliationPriorYearIncomeTaxes" xlink:type="arc"/>
    <link:presentationArc order="5" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="hstm_EffectiveIncomeTaxRateReconciliationChangeInUncertainTaxPositionsAmount" xlink:type="arc"/>
    <link:presentationArc order="6" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_IncomeTaxReconciliationOtherAdjustments" xlink:type="arc"/>
    <link:presentationArc order="7" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_IncomeTaxExpenseBenefit-3" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-note-9-income-taxes-reconciliation-of-the-beginning-and-ending-liability-for-gross-unrecognized-tax-benefits-details" xlink:href="hstm-20241231.xsd#statement-note-9-income-taxes-reconciliation-of-the-beginning-and-ending-liability-for-gross-unrecognized-tax-benefits-details" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-note-9-income-taxes-reconciliation-of-the-beginning-and-ending-liability-for-gross-unrecognized-tax-benefits-details" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_statement-statement-note-9-income-taxes-reconciliation-of-the-beginning-and-ending-liability-for-gross-unrecognized-tax-benefits-details" xlink:label="hstm_statement-statement-note-9-income-taxes-reconciliation-of-the-beginning-and-ending-liability-for-gross-unrecognized-tax-benefits-details" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_UnrecognizedTaxBenefits" xlink:label="us-gaap_UnrecognizedTaxBenefits-4" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_UnrecognizedTaxBenefits" xlink:label="us-gaap_UnrecognizedTaxBenefits-5" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_UnrecognizedTaxBenefitsDecreasesResultingFromPriorPeriodTaxPositions" xlink:label="us-gaap_UnrecognizedTaxBenefitsDecreasesResultingFromPriorPeriodTaxPositions-n8" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_UnrecognizedTaxBenefitsDecreasesResultingFromSettlementsWithTaxingAuthorities" xlink:label="us-gaap_UnrecognizedTaxBenefitsDecreasesResultingFromSettlementsWithTaxingAuthorities-n8" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_UnrecognizedTaxBenefitsIncreasesResultingFromCurrentPeriodTaxPositions" xlink:label="us-gaap_UnrecognizedTaxBenefitsIncreasesResultingFromCurrentPeriodTaxPositions" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_statement-statement-note-9-income-taxes-reconciliation-of-the-beginning-and-ending-liability-for-gross-unrecognized-tax-benefits-details" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/periodStartLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_UnrecognizedTaxBenefits-4" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_UnrecognizedTaxBenefitsIncreasesResultingFromCurrentPeriodTaxPositions" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_UnrecognizedTaxBenefitsDecreasesResultingFromPriorPeriodTaxPositions-n8" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_UnrecognizedTaxBenefitsDecreasesResultingFromSettlementsWithTaxingAuthorities-n8" xlink:type="arc"/>
    <link:presentationArc order="4" preferredLabel="http://www.xbrl.org/2003/role/periodEndLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_UnrecognizedTaxBenefits-5" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-note-10-stock-based-compensation-stock-based-compensation-expense-details" xlink:href="hstm-20241231.xsd#statement-note-10-stock-based-compensation-stock-based-compensation-expense-details" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-note-10-stock-based-compensation-stock-based-compensation-expense-details" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_ProductDevelopmentMember" xlink:label="hstm_ProductDevelopmentMember" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_statement-statement-note-10-stock-based-compensation-stock-based-compensation-expense-details" xlink:label="hstm_statement-statement-note-10-stock-based-compensation-stock-based-compensation-expense-details" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_AllocatedShareBasedCompensationExpense" xlink:label="us-gaap_AllocatedShareBasedCompensationExpense" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_CostOfSalesMember" xlink:label="us-gaap_CostOfSalesMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_GeneralAndAdministrativeExpenseMember" xlink:label="us-gaap_GeneralAndAdministrativeExpenseMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_IncomeStatementLocationAxis" xlink:label="us-gaap_IncomeStatementLocationAxis" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_IncomeStatementLocationDomain" xlink:label="us-gaap_IncomeStatementLocationDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_SellingAndMarketingExpenseMember" xlink:label="us-gaap_SellingAndMarketingExpenseMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_statement-statement-note-10-stock-based-compensation-stock-based-compensation-expense-details" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeStatementLocationAxis" xlink:to="us-gaap_IncomeStatementLocationDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_IncomeStatementLocationAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeStatementLocationAxis" xlink:to="us-gaap_CostOfSalesMember" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeStatementLocationAxis" xlink:to="hstm_ProductDevelopmentMember" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeStatementLocationAxis" xlink:to="us-gaap_SellingAndMarketingExpenseMember" xlink:type="arc"/>
    <link:presentationArc order="4" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeStatementLocationAxis" xlink:to="us-gaap_GeneralAndAdministrativeExpenseMember" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_AllocatedShareBasedCompensationExpense" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-note-3-net-income-per-share-computation-of-basic-and-diluted-earnings-per-share-details" xlink:href="hstm-20241231.xsd#statement-note-3-net-income-per-share-computation-of-basic-and-diluted-earnings-per-share-details" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-note-3-net-income-per-share-computation-of-basic-and-diluted-earnings-per-share-details" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_statement-statement-note-3-net-income-per-share-computation-of-basic-and-diluted-earnings-per-share-details" xlink:label="hstm_statement-statement-note-3-net-income-per-share-computation-of-basic-and-diluted-earnings-per-share-details" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_EarningsPerShareAbstract" xlink:label="us-gaap_EarningsPerShareAbstract" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_EarningsPerShareBasic" xlink:label="us-gaap_EarningsPerShareBasic" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_EarningsPerShareDiluted" xlink:label="us-gaap_EarningsPerShareDiluted" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_IncrementalCommonSharesAttributableToShareBasedPaymentArrangements" xlink:label="us-gaap_IncrementalCommonSharesAttributableToShareBasedPaymentArrangements" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_NetIncomeLoss" xlink:label="us-gaap_NetIncomeLoss" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_WeightedAverageNumberOfDilutedSharesOutstanding" xlink:label="us-gaap_WeightedAverageNumberOfDilutedSharesOutstanding-3" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_WeightedAverageNumberOfSharesOutstandingBasic" xlink:label="us-gaap_WeightedAverageNumberOfSharesOutstandingBasic-2" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_statement-statement-note-3-net-income-per-share-computation-of-basic-and-diluted-earnings-per-share-details" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_NetIncomeLoss" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_WeightedAverageNumberOfSharesOutstandingBasic-2" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_IncrementalCommonSharesAttributableToShareBasedPaymentArrangements" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_WeightedAverageNumberOfDilutedSharesOutstanding-3" xlink:type="arc"/>
    <link:presentationArc order="4" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_EarningsPerShareAbstract" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EarningsPerShareAbstract" xlink:to="us-gaap_EarningsPerShareBasic" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EarningsPerShareAbstract" xlink:to="us-gaap_EarningsPerShareDiluted" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-note-4-marketable-securities-fair-value-of-available-for-sale-marketable-securities-details" xlink:href="hstm-20241231.xsd#statement-note-4-marketable-securities-fair-value-of-available-for-sale-marketable-securities-details" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-note-4-marketable-securities-fair-value-of-available-for-sale-marketable-securities-details" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_statement-statement-note-4-marketable-securities-fair-value-of-available-for-sale-marketable-securities-details" xlink:label="hstm_statement-statement-note-4-marketable-securities-fair-value-of-available-for-sale-marketable-securities-details" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_AvailableForSaleDebtSecuritiesAccumulatedGrossUnrealizedGainBeforeTax" xlink:label="us-gaap_AvailableForSaleDebtSecuritiesAccumulatedGrossUnrealizedGainBeforeTax" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_AvailableForSaleDebtSecuritiesAccumulatedGrossUnrealizedLossBeforeTax" xlink:label="us-gaap_AvailableForSaleDebtSecuritiesAccumulatedGrossUnrealizedLossBeforeTax-n8" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_AvailableForSaleDebtSecuritiesAmortizedCostBasis" xlink:label="us-gaap_AvailableForSaleDebtSecuritiesAmortizedCostBasis" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_AvailableForSaleSecuritiesDebtSecurities" xlink:label="us-gaap_AvailableForSaleSecuritiesDebtSecurities-2" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_FairValueByFairValueHierarchyLevelAxis" xlink:label="us-gaap_FairValueByFairValueHierarchyLevelAxis" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_FairValueInputsLevel2Member" xlink:label="us-gaap_FairValueInputsLevel2Member" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_FairValueMeasurementsFairValueHierarchyDomain" xlink:label="us-gaap_FairValueMeasurementsFairValueHierarchyDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_FinancialInstrumentAxis" xlink:label="us-gaap_FinancialInstrumentAxis" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_TransfersAndServicingOfFinancialInstrumentsTypesOfFinancialInstrumentsDomain" xlink:label="us-gaap_TransfersAndServicingOfFinancialInstrumentsTypesOfFinancialInstrumentsDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_USTreasurySecuritiesMember" xlink:label="us-gaap_USTreasurySecuritiesMember" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_statement-statement-note-4-marketable-securities-fair-value-of-available-for-sale-marketable-securities-details" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FinancialInstrumentAxis" xlink:to="us-gaap_TransfersAndServicingOfFinancialInstrumentsTypesOfFinancialInstrumentsDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FairValueByFairValueHierarchyLevelAxis" xlink:to="us-gaap_FairValueMeasurementsFairValueHierarchyDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_FinancialInstrumentAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FinancialInstrumentAxis" xlink:to="us-gaap_USTreasurySecuritiesMember" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_FairValueByFairValueHierarchyLevelAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FairValueByFairValueHierarchyLevelAxis" xlink:to="us-gaap_FairValueInputsLevel2Member" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_AvailableForSaleDebtSecuritiesAmortizedCostBasis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_AvailableForSaleDebtSecuritiesAccumulatedGrossUnrealizedGainBeforeTax" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_AvailableForSaleDebtSecuritiesAccumulatedGrossUnrealizedLossBeforeTax-n8" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_AvailableForSaleSecuritiesDebtSecurities-2" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-note-10-stock-based-compensation-stock-option-activity-details" xlink:href="hstm-20241231.xsd#statement-note-10-stock-based-compensation-stock-option-activity-details" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-note-10-stock-based-compensation-stock-option-activity-details" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_statement-statement-note-10-stock-based-compensation-stock-option-activity-details" xlink:label="hstm_statement-statement-note-10-stock-based-compensation-stock-option-activity-details" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisableNumber" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisableNumber" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisableWeightedAverageExercisePrice" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisableWeightedAverageExercisePrice" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExpirationsInPeriod" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExpirationsInPeriod" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsForfeituresInPeriod" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsForfeituresInPeriod" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsGrantsInPeriodGross" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsGrantsInPeriodGross" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingIntrinsicValue" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingIntrinsicValue" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingNumber" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingNumber-4" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingNumber" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingNumber-5" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePrice" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePrice-4" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePrice" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePrice-5" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsExercisesInPeriodWeightedAverageExercisePrice" xlink:label="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsExercisesInPeriodWeightedAverageExercisePrice" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsExpirationsInPeriodWeightedAverageExercisePrice" xlink:label="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsExpirationsInPeriodWeightedAverageExercisePrice" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsForfeituresInPeriodWeightedAverageExercisePrice" xlink:label="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsForfeituresInPeriodWeightedAverageExercisePrice" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsGrantsInPeriodWeightedAverageExercisePrice" xlink:label="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsGrantsInPeriodWeightedAverageExercisePrice" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableIntrinsicValue1" xlink:label="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableIntrinsicValue1" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StockIssuedDuringPeriodSharesStockOptionsExercised" xlink:label="us-gaap_StockIssuedDuringPeriodSharesStockOptionsExercised" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_statement-statement-note-10-stock-based-compensation-stock-option-activity-details" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/periodStartLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingNumber-4" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/periodStartLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePrice-4" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsGrantsInPeriodGross" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsGrantsInPeriodWeightedAverageExercisePrice" xlink:type="arc"/>
    <link:presentationArc order="4" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_StockIssuedDuringPeriodSharesStockOptionsExercised" xlink:type="arc"/>
    <link:presentationArc order="5" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsExercisesInPeriodWeightedAverageExercisePrice" xlink:type="arc"/>
    <link:presentationArc order="6" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExpirationsInPeriod" xlink:type="arc"/>
    <link:presentationArc order="7" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsExpirationsInPeriodWeightedAverageExercisePrice" xlink:type="arc"/>
    <link:presentationArc order="8" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsForfeituresInPeriod" xlink:type="arc"/>
    <link:presentationArc order="9" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsForfeituresInPeriodWeightedAverageExercisePrice" xlink:type="arc"/>
    <link:presentationArc order="10" preferredLabel="http://www.xbrl.org/2003/role/periodEndLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingNumber-5" xlink:type="arc"/>
    <link:presentationArc order="11" preferredLabel="http://www.xbrl.org/2003/role/periodEndLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePrice-5" xlink:type="arc"/>
    <link:presentationArc order="12" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingIntrinsicValue" xlink:type="arc"/>
    <link:presentationArc order="13" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisableNumber" xlink:type="arc"/>
    <link:presentationArc order="14" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisableWeightedAverageExercisePrice" xlink:type="arc"/>
    <link:presentationArc order="15" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableIntrinsicValue1" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-note-10-stock-based-compensation-rsus-activities-details" xlink:href="hstm-20241231.xsd#statement-note-10-stock-based-compensation-rsus-activities-details" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-note-10-stock-based-compensation-rsus-activities-details" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_statement-statement-note-10-stock-based-compensation-rsus-activities-details" xlink:label="hstm_statement-statement-note-10-stock-based-compensation-rsus-activities-details" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_AwardTypeAxis" xlink:label="us-gaap_AwardTypeAxis" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_RestrictedStockUnitsRSUMember" xlink:label="us-gaap_RestrictedStockUnitsRSUMember" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeitedInPeriod" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeitedInPeriod-n8" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeituresWeightedAverageGrantDateFairValue" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeituresWeightedAverageGrantDateFairValue" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriod" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriod" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedNumber" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedNumber-4" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedNumber" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedNumber-5" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValue" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValue-4" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValue" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValue-5" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriod" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriod-n8" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodWeightedAverageGrantDateFairValue" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodWeightedAverageGrantDateFairValue" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:label="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardEquityInstrumentsOtherThanOptionsAggregateIntrinsicValueOutstanding" xlink:label="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardEquityInstrumentsOtherThanOptionsAggregateIntrinsicValueOutstanding" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_statement-statement-note-10-stock-based-compensation-rsus-activities-details" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AwardTypeAxis" xlink:to="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_AwardTypeAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AwardTypeAxis" xlink:to="us-gaap_RestrictedStockUnitsRSUMember" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/periodStartLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedNumber-4" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/periodStartLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValue-4" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriod" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue" xlink:type="arc"/>
    <link:presentationArc order="4" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriod-n8" xlink:type="arc"/>
    <link:presentationArc order="5" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodWeightedAverageGrantDateFairValue" xlink:type="arc"/>
    <link:presentationArc order="6" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeitedInPeriod-n8" xlink:type="arc"/>
    <link:presentationArc order="7" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeituresWeightedAverageGrantDateFairValue" xlink:type="arc"/>
    <link:presentationArc order="8" preferredLabel="http://www.xbrl.org/2003/role/periodEndLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedNumber-5" xlink:type="arc"/>
    <link:presentationArc order="9" preferredLabel="http://www.xbrl.org/2003/role/periodEndLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValue-5" xlink:type="arc"/>
    <link:presentationArc order="10" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardEquityInstrumentsOtherThanOptionsAggregateIntrinsicValueOutstanding" xlink:type="arc"/>
  </link:presentationLink>
  <link:roleRef roleURI="http://www.healthstream.com/20241231/role/statement-note-13-leases-leaserelated-assets-and-liabilities-details" xlink:href="hstm-20241231.xsd#statement-note-13-leases-leaserelated-assets-and-liabilities-details" xlink:type="simple"/>
  <link:presentationLink xlink:role="http://www.healthstream.com/20241231/role/statement-note-13-leases-leaserelated-assets-and-liabilities-details" xlink:type="extended">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_EntityDomain" xlink:label="dei_EntityDomain" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2024/dei-2024.xsd#dei_LegalEntityAxis" xlink:label="dei_LegalEntityAxis" xlink:type="locator"/>
    <link:loc xlink:href="hstm-20241231.xsd#hstm_statement-statement-note-13-leases-leaserelated-assets-and-liabilities-details" xlink:label="hstm_statement-statement-note-13-leases-leaserelated-assets-and-liabilities-details" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_OperatingLeaseLiability" xlink:label="us-gaap_OperatingLeaseLiability-3" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_OperatingLeaseLiabilityCurrent" xlink:label="us-gaap_OperatingLeaseLiabilityCurrent-1" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_OperatingLeaseLiabilityCurrentStatementOfFinancialPositionExtensibleList" xlink:label="us-gaap_OperatingLeaseLiabilityCurrentStatementOfFinancialPositionExtensibleList" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_OperatingLeaseLiabilityNoncurrent" xlink:label="us-gaap_OperatingLeaseLiabilityNoncurrent" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_OperatingLeaseRightOfUseAsset" xlink:label="us-gaap_OperatingLeaseRightOfUseAsset" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems" xlink:type="locator"/>
    <link:loc xlink:href="https://xbrl.fasb.org/us-gaap/2024/elts/us-gaap-2024.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable" xlink:type="locator"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="hstm_statement-statement-note-13-leases-leaserelated-assets-and-liabilities-details" xlink:to="us-gaap_StatementTable" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_LegalEntityAxis" xlink:to="dei_EntityDomain" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="dei_LegalEntityAxis" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" xlink:type="arc"/>
    <link:presentationArc order="0" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_OperatingLeaseRightOfUseAsset" xlink:type="arc"/>
    <link:presentationArc order="1" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_OperatingLeaseLiabilityCurrentStatementOfFinancialPositionExtensibleList" xlink:type="arc"/>
    <link:presentationArc order="2" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_OperatingLeaseLiabilityCurrent-1" xlink:type="arc"/>
    <link:presentationArc order="3" preferredLabel="http://www.xbrl.org/2003/role/label" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_OperatingLeaseLiabilityNoncurrent" xlink:type="arc"/>
    <link:presentationArc order="4" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" xbrldt:closed="true" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_OperatingLeaseLiability-3" xlink:type="arc"/>
  </link:presentationLink>
</link:linkbase>
