Intuitive Surgical (ISRG) Q4 2025 earnings summary

Executive summary

• 2025 saw strong global growth in multi-specialty da Vinci procedures, increased adoption of da Vinci 5, and higher utilization across all platforms, with over 3.1 million patients treated and more than 20 million since inception.

• Strategic priorities included full launch of da Vinci 5, increased adoption by country, manufacturing optimization, and digital tool excellence, all showing significant progress.

• International procedures grew 23%, with robust growth in Europe, Asia, and rest of world, now accounting for 35% of global procedures.

• Worldwide procedures grew 18% year-over-year, with da Vinci up 17% and Ion up 44%.

• 532 da Vinci systems placed in Q4 2025, up from 493 in Q4 2024; da Vinci 5 placements more than doubled.

Financial highlights

• Revenue grew 21% year-over-year to $10.1 billion in 2025.

• Q4 2025 revenue was $2.87B, up 19% from $2.41B in Q4 2024.

• Pro forma EPS increased 22% year-over-year, with free cash flow rising to $2.5 billion from $1.3 billion in 2024.

• Q4 2025 GAAP net income was $795M ($2.21/diluted share), up from $686M ($1.88/diluted share) year-over-year.

• Ended the year with $9 billion in cash and investments.

Outlook and guidance

• 2026 da Vinci procedure growth expected at 13%-15%, with primary drivers similar to 2025.

• Pro forma gross profit margin forecasted at 67%-68% of net revenue, with 1.2% impact from tariffs.

• Pro forma operating expense growth expected at 11%-15%, reflecting R&D and distributor acquisition costs.

• 2026 pro forma income tax rate estimated at 22%-23%.