Boston Scientific (BSX) Q4 2025 earnings summary

Executive summary

• Q4 2025 consolidated revenue was $5.286B, up 15.9% year-over-year, with organic growth of 12.7%; full-year revenue reached $20.074B, up 19.9% year-over-year, exceeding guidance.

• Adjusted EPS for Q4 was $0.80 (up from $0.70), and full-year adjusted EPS was $3.06, both above guidance.

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

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

• Six of eight business units grew faster than the market, with standout performance in EP and Watchman franchises.

Financial highlights

• Adjusted gross margin for 2025 was 70.6%, up 30 bps year-over-year; Q4 gross margin was 69.6%.

• Adjusted operating margin expanded 100 bps to 28% for the year; Q4 operating margin was 15.6%.

• Free cash flow for 2025 was $3.659B, up 38% year-over-year, with 80% conversion.

• Cash on hand at year-end was $1.965B; gross debt leverage ratio at 1.9x.

• Q4 net income attributable to common stockholders was $672M as reported, $1.201B adjusted.

Outlook and guidance

• 2026 organic revenue growth guided at 10%-11%; Q1 organic growth expected at 8.5%-10%.

• Full-year 2026 adjusted EPS guidance is $3.43-$3.49, representing 12%-14% growth.

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

• Free cash flow for 2026 expected at ~$4.2B.