Intuitive Surgical (ISRG) Q4 2024 earnings summary

Executive summary

• Achieved strong financial and operational performance in 2024, driven by robust adoption of da Vinci 5 and healthy global procedure growth, especially in general surgery and key international markets.

• Q4 2024 revenue rose 25% year-over-year to $2.41 billion, driven by 18% growth in da Vinci procedures and a 15% increase in installed systems base.

• Expanded product portfolio and global reach, including acquisition of direct operations in Italy, Spain, and Portugal.

• Continued innovation with new features and digital tools, and significant R&D investment to support future growth.

• Ended Q4 2024 with $8.83 billion in cash, cash equivalents, and investments, up $521 million sequentially.

Financial highlights

• 2024 revenue reached $8.4 billion, up 17% year-over-year, with 84% recurring revenue.

• Net income grew 29% year-over-year; pro forma EPS increased 28%.

• Q4 revenue was $2.41 billion, up 25% year-over-year; Q4 pro forma net income was $805 million ($2.21/share).

• Instruments and accessories revenue grew 23% year-over-year to $1.41 billion in Q4 2024.

• Full-year 2024 GAAP net income was $2.32 billion ($6.42 per diluted share).

Outlook and guidance

• 2025 procedure growth expected at 13%-16%, with lower growth assumptions for China and Europe at the low end.

• 2025 pro forma/non-GAAP gross margin guided to 67%-68% due to higher depreciation, product mix, and FX headwinds.

• Operating expense growth expected at 10%-15% in 2025, with continued R&D prioritization.

• Guidance does not include potential impact of new tariffs, which could be material.

• Pro forma income tax rate for 2025 estimated at 22%-23%.