Boston Scientific (BSX) Q4 2025 earnings summary

Executive summary

• Q4 2025 net sales grew 15.9% reported, reaching $5.286B; full-year net sales were $20.074B, up 19.9% year-over-year.

• Adjusted EPS was $0.80 in Q4 and $3.06 for the year, both exceeding guidance.

• Major product launches and regulatory approvals included SEISMIQ M IVL System, FARAPOINT PFA Catheter, and TheraSphere 360 Y-90 Management Platform.

• Six of eight business units outpaced market growth, with strong global performance in EP, Watchman, and cardiovascular segments.

• Completed acquisition of Nalu Medical and announced agreements to acquire Valencia Technologies and Penumbra.

Financial highlights

• Q4 gross margin was 69.6% as reported; adjusted gross margin 70.7%; Q4 operating margin was 15.6% as reported, adjusted operating margin 27.3%.

• Full-year free cash flow was $3.66B, with 80% conversion.

• Q4 adjusted net income was $1.201B; full-year adjusted net income was $4.574B.

• Q4 GAAP net income was $672M; full-year GAAP net income was $2.898B.

• Year-end cash on hand was $1.965B; year-end debt was $11.4B.

Outlook and guidance

• FY 2026 net sales growth guidance: 10.5%-11.5% reported, 10.0%-11.0% organic; adjusted EPS guidance: $3.43-$3.49.

• Q1 2026 net sales growth guidance: 10.5%-12.0% reported, 8.5%-10.0% organic; adjusted EPS guidance: $0.78-$0.80.

• Estimated FY 2026 free cash flow is ~$4.2B.

• Adjusted operating margin expected to expand 50-75 bps in 2026.

• Long-range plan targets: 10%+ sales growth, 150 bps margin expansion, double-digit EPS growth through 2028.