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Bonus Article from MarketBeat Media

Intuitive Surgical Just Proved the Growth Engine Still Runs

Reported by Leo Miller. Posted: 1/23/2026. 

Summary

• Intuitive Surgical’s Q4 2025 results beat on both revenue and EPS, reinforcing confidence in its robotics‑assisted surgery leadership despite a deceleration in procedure growth.
• Guidance for 2026 shows steady procedural demand and gross margins, with investment in R&D and new platforms (Ion, da Vinci SP) supporting long‑term growth prospects.
• Tariff headwinds and a high valuation present near‑term risks, but investor resilience and market trust underpin sustained growth expectations.

Robotic-assisted surgery stalwart Intuitive Surgical (NASDAQ: ISRG) surprised investors with its Q3 2025 earnings report in October 2025. Shares closed nearly 14% higher after the release, marking the healthcare stock’s largest single-day post-earnings gain in recent memory.

On Jan. 22, the company reported its Q4 2025 results. While the report didn’t generate quite the same fanfare, the market received it positively — the stock rose roughly 1.4% in after-hours trading. Despite a lofty valuation, Intuitive still presents a constructive long-term outlook, with its growth engine largely intact.

Intuitive Beats on Revenue and EPS by a Solid Margin

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In Q4, Intuitive posted revenue of $2.87 billion, up 19% year over year, well above estimates of $2.72 billion (about 13% growth). The company’s adjusted earnings per share (EPS) were arguably even more impressive: $2.53, up just over 14%, versus analysts’ expectations of $2.25 (roughly flat growth).

Growth in da Vinci procedures remains a key performance indicator for the company. More procedures typically translate into higher sales of disposable instruments, which are a major source of recurring revenue and often account for the bulk of Intuitive’s total sales.

Da Vinci procedure volume rose 17% in the quarter, consistent with the company’s two-year historical range. That figure represents a deceleration from the 19% growth reported in the prior quarter, which had been a standout not seen since 2023. For the full year, da Vinci procedures were up 18%.

Intuitive Provides Solid Guidance, but Growth May Decelerate

For 2026, Intuitive expects da Vinci procedure growth of about 14% at the midpoint. The company doesn’t provide an explicit revenue-growth forecast tied to this metric, but revenue typically moves in the same direction as procedure volumes. Intuitive projects gross margin of 67% to 68% for 2026, effectively in line with its 2025 gross margin of 67.7%.

Management also anticipates operating expenses will rise slightly faster in 2026 than in 2025, which could compress operating margin if revenue growth moderates alongside procedure growth. The company attributes the faster expense growth largely to early-stage research and development investments.

While those investments could be dilutive in the near term, they support the company’s long-term growth prospects. Sustaining elevated growth depends in part on developing new devices and platforms and obtaining approvals for additional indications. Intuitive’s Ion and da Vinci SP platforms illustrate its ability to find new growth drivers: procedures for those systems grew 78% and 51%, respectively, during the quarter.

Markets Look Past Intuitive’s Tariff Guidance, Mitigating a Key Headwind

Investors also appeared untroubled by Intuitive’s tariff-related guidance. The company expects tariffs to reduce gross margin by about 1.2% in 2026, versus an approximately 65-basis-point impact in 2025. That the shares held up despite the larger expected hit is notable given that tariff concerns weighed on the stock much of last year. With clearer visibility into tariff exposure, uncertainty around the stock has diminished and investor confidence has improved.

Intuitive Surgical is not cheap — it trades at a forward price-to-earnings (P/E) ratio near 56x — but it has established itself as a leader in robotic-assisted surgery and earned trust within the healthcare industry. That credibility should help as it expands into new markets, giving it an advantage over aspiring competitors and making sustained growth a realistic possibility. Still, the company must continue to innovate to sustain growth rates that justify its current valuation and support further appreciation in the stock price.

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