Establishment Labs (ESTA) Q4 2025 earnings summary

Executive summary

• Q4 2025 revenue reached $64.6 million, up 45.2% year-over-year, with full-year revenue at $211.1 million, a 27.2% increase over 2024.

• US Motiva revenue was $17.3 million in Q4 and $45.6 million for the full year.

• Net loss from operations in Q4 was $3.9 million, down 79% from Q4 2024; adjusted EBITDA was +$5.5 million, a significant turnaround from -$13.1 million last year.

• Ended 2025 with $75.6 million in cash, up $4.9 million sequentially, and no need for additional capital.

• Management transition announced: Raj Denhoy to SVP, Global Strategy; Cassandra Harris appointed CFO.

Financial highlights

• Q4 gross profit was $45.5 million (70.5% margin), up from $30.5 million (68.5% margin) in Q4 2024.

• SG&A expenses were $44.0 million, flat year-over-year; total operating expenses for Q4 were $49.5 million.

• R&D expenses for Q4 were $5.4 million.

• Adjusted EBITDA improved by $18.6 million year-over-year in Q4.

• Full-year net loss was $51.1 million, improved from $84.6 million in 2024.

Outlook and guidance

• 2026 revenue guidance is $264–$266 million, representing 25–26% growth over 2025.

• 2027 revenue growth is projected to be at least 25%.

• US expected to exceed 30% of overall sales in 2026, up from 22% in 2025.

• Gross margins projected to increase by 200–300 basis points in 2026.

• Adjusted EBITDA positive every quarter in 2026; cash flow positive expected in 2026, with no further equity raises needed.

• 2027 expected to be cash flow positive for the full year, with further margin improvement.