Boston Scientific (BSX) Q4 2025 earnings summary

Executive summary

• Q4 2025 net sales grew 15.9% reported and 12.7% organic year-over-year, with adjusted EPS at $0.80, up from $0.70 in Q4 2024; full-year net sales reached $20.074B, up 19.9% reported and 15.8% organic, with adjusted EPS at $3.06.

• Six out of eight business units outpaced market growth, with standout performances in EP, Watchman, and cardiovascular segments.

• 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, both expected to close in 2026.

• Strong performance attributed to innovation, operational execution, and global team efforts.

Financial highlights

• Q4 consolidated revenue: $5.286B (+15.9% reported, +12.7% organic); full-year revenue: $20.074B (+19.9% reported, +15.8% organic).

• Q4 adjusted EPS: $0.80 (+15% YoY); full-year adjusted EPS: $3.06 (+22% YoY).

• Q4 gross margin: 69.6% as reported, 70.7% adjusted; full-year gross margin: 69.0% as reported, 70.6% adjusted.

• Q4 adjusted operating margin: 27.3%; full-year adjusted operating margin: 28.0%.

• Free cash flow: $1.013B in Q4, $3.659B for the year (80% conversion).

Outlook and guidance

• 2026 organic revenue growth guidance: 8.5%-10% for Q1, 10%-11% for full year; adjusted EPS guidance: $3.43-$3.49 (+12%-14% YoY).

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

• Free cash flow expected at ~$4.2B in 2026, with 70%-80% conversion target.

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