Establishment Labs (ESTA) Q4 2025 earnings summary

Executive summary

• Q4 2025 revenue reached $64.6 million, up 45.2% year-over-year, with US Motiva revenue at $17.3 million and full-year revenue at $211.1 million, a 27.2% increase over 2024.

• Operational leverage improved, with gross margin exceeding 70% for the second consecutive quarter.

• Adjusted EBITDA turned positive at $5.5 million in Q4, compared to a loss of $13.1 million in Q4 2024.

• Net loss from operations for Q4 was $3.9 million, a 79% reduction from the prior year.

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

Financial highlights

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

• SG&A expenses were flat at $44.0 million in Q4; total operating expenses were $49.5 million.

• R&D expenses rose slightly to $5.4 million due to personnel and regulatory costs.

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

• Cash increased by $4.9 million in Q4, primarily from reduced operating cash use and option exercises.

Outlook and guidance

• 2026 revenue guidance is $264–$266 million, representing 25%+ 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 rise by 200–300 basis points in 2026.

• Free cash use in 2026 to be less than half of 2025; company expects to be cash flow positive in 2026.