Boston Scientific (BSX) Q1 2026 earnings summary

Executive summary

• Q1 2026 net sales reached $5.203 billion, up 11.6% year-over-year reported and 9.4% organic, with adjusted EPS up 6% to $0.80 and adjusted operating margin at 28%.

• GAAP net income attributable to common stockholders was $1.341 billion ($0.90 per share), more than doubling year-over-year.

• U.S. operational growth was 11%, EMEA 1% (impacted by product discontinuations), and Asia-Pac 12–14.7% with strong performance in Japan and China.

• Key product launches, regulatory approvals, and positive clinical trial results (WATCHMAN FLX, EKOS, OPAL HDx, Asurys) supported growth.

• Full-year 2026 organic growth guidance reduced to 6.5%-8% due to headwinds in EP, WATCHMAN, and Urology.

Financial highlights

• Q1 consolidated revenue was $5.203 billion, up from $4.663 billion in Q1 2025.

• Adjusted gross margin declined 100 bps to 70.5% due to tariffs and inventory charges; gross profit was $3.614 billion.

• Free cash flow for Q1 was $170 million; cash on hand at quarter-end was $1.453 billion; debt to adjusted EBITDA ratio at 1.8x.

• Full-year 2026 adjusted EPS guidance is $3.34-$3.41 (9%-11% growth), including a $0.04 FX headwind.

Outlook and guidance

• Q2 2026 adjusted EPS guided at $0.82-$0.84; full-year adjusted operating margin expected to expand 50-75 bps.

• Full-year reported revenue growth expected at 7.0%-8.5%, with organic growth at 6.5%-8.0%.

• Guidance excludes the pending Penumbra acquisition, expected to close in H2 2026.

• Management expects a stronger second half as supply chain and commercial disruptions ease.