Pulmonx (LUNG) Q4 2025 earnings summary

Executive summary

• Leadership conducted a comprehensive review, realigned cost structure, and prioritized high-return programs to balance growth and profitability.

• Top priorities are re-accelerating U.S. sales growth, advancing clinical initiatives, and aligning spending for financial leverage.

• Significant internal operational and executional challenges led to U.S. underperformance in 2025, including sales force turnover and suboptimal incentive structures.

• New leadership and streamlined commercial focus aim to rebuild momentum, with most U.S. sales positions now filled and productivity expected to ramp in the second half of 2026.

• Full year 2025 worldwide revenue reached $90.5M, up 8% year-over-year; Q4 revenue was $22.6M, down 5% from Q4 2024.

• Gross margin improved to 78% in Q4 2025 and held at 74% for the full year.

• Net loss narrowed to $54.0M for 2025 ($1.33/share) from $56.4M in 2024 ($1.44/share).

• Cost restructuring and debt refinancing initiatives were executed to support future growth and profitability.

Financial highlights

• Q4 2025 worldwide revenue was $22.6M, down 5% year-over-year; full-year 2025 revenue was $90.5M, up 8%.

• U.S. Q4 revenue was $14.1M, down 11% year-over-year; full-year U.S. revenue was $57M, up 1%.

• International Q4 revenue was $8.5M, up 8% year-over-year; full-year international revenue was $33.5M, up 23%.

• Q4 2025 gross margin was 78% (vs. 74% prior year); full-year gross margin was 74%.

• Q4 net loss was $10.4M ($0.25/share), improved from $13.2M ($0.33/share) prior year; full-year net loss was $54M ($1.33/share).

• Adjusted EBITDA loss for Q4 was $5.5M (vs. $7.5M prior year); full-year adjusted EBITDA loss was $30.6M.

• Ended 2025 with $69.8M in cash equivalents and marketable securities.

• Operating expenses for 2025 were $120.8M, up 1% from 2024.

Outlook and guidance

• 2026 revenue expected between $90M-$92M, with growth resuming in both U.S. and international businesses in the back half.

• Gross margin for 2026 projected at ~75%, trending higher in H1 and lower in H2 as distributor sales increase.

• Operating expenses for 2026 guided at $113M-$115M, including ~$21M in stock-based compensation; excluding this, a 7%-9% decrease from 2025.

• Annual cash burn expected to decrease from $32M in 2025 to $23M in 2026.

• Double-digit global growth anticipated by Q4 2026.

• Cash and equivalents expected to decrease by ~$23M in 2026, assuming no further credit facility drawdowns.