Boston Scientific (BSX) Q1 2026 earnings summary

Executive summary

• Q1 2026 net sales reached $5.203 billion, up 11.6% year-over-year (9.4% organic), driven by innovation and strong commercial execution, especially in Electrophysiology and Cardiovascular segments.

• Adjusted EPS rose 6% to $0.80, with GAAP EPS at $0.90; net income attributable to common stockholders nearly doubled to $1.341 billion, aided by a discrete tax benefit.

• Gross margin improved to 69.4% (+60 bps), while adjusted gross margin was 70.5% (-100 bps); adjusted operating margin was 28.0%.

• Key product launches, regulatory approvals, and clinical trial successes (WATCHMAN FLX, EKOS, OPAL HDx, Asurys) supported operational momentum.

• Major acquisitions announced or completed include Valencia Technologies, Nalu Medical, and the pending $14.5 billion Penumbra deal.

Financial highlights

• Q1 consolidated revenue was $5.203 billion, up from $4.663 billion in Q1 2025.

• Free cash flow for Q1 was $170 million; cash on hand at quarter-end was $1.453 billion; debt to adjusted EBITDA ratio stood at 1.8x.

• Gross profit for Q1 2026 was $3.614 billion; operating income rose to $1.101 billion.

• Adjusted net income was $1.189 billion ($0.80 per share), up from $1.121 billion ($0.75 per share) last year.

• Capital expenditures for Q1 2026 totaled $177 million.

Outlook and guidance

• Full-year 2026 net sales growth expected at 7.0%-8.5% reported and 6.5%-8.0% organic; adjusted EPS guidance is $3.34-$3.41.

• Q2 2026 net sales growth projected at 5.5%-7.5% reported and 5.0%-7.0% organic; adjusted EPS guidance is $0.82-$0.84.

• Full-year adjusted operating margin expected to expand 50-75 bps; adjusted tax rate for FY 2026 estimated at ~12%.

• Guidance excludes the pending Penumbra acquisition, expected to close in H2 2026.

• Management expects a stronger second half as supply chain and commercial disruptions ease.