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 total 2025 revenue at $211.1 million, a 27.2% increase over 2024.

• Operational leverage improved, with gross margin exceeding 70% for the second consecutive quarter and adjusted EBITDA turning positive at $5.5 million in Q4.

• Net loss from operations in Q4 was $3.9 million, down 79% from Q4 2024, and full-year net loss was $51.1 million, improved from $84.6 million in 2024.

• Cash balance at year-end 2025 was $75.6 million, up $4.9 million sequentially from Q3.

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

Financial highlights

• Q4 2025 gross profit was $45.5 million, or 70.5% of revenue, up 200 basis points year-over-year.

• Adjusted EBITDA for Q4 was $5.5 million, a significant improvement from a loss of $13.1 million in Q4 2024.

• SG&A expenses were $44.0 million, flat year-over-year; R&D expenses rose to $5.4 million due to personnel and regulatory costs.

• Total operating expenses for Q4 were $49.5 million.

• Basic and diluted net loss per share for Q4 was $0.09, improved from $1.19 in Q4 2024.

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%.

• First positive cash flow quarter expected in 2026, with full-year positive cash flow anticipated in 2027.

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

• Free cash use in 2026 expected to be less than half of 2025, with no need for additional capital.