The surgical robotics company’s process growth remained impressive, supporting recurring revenue.
Intuitive Surgical’s Da Vinci 5 adoption is accelerating.
Ion sales are growing faster than its core da Vinci platform.
10 Stocks We Like Better Than Easy Surgical
shares of Easy surgical(NASDAQ: ISRG ) Thursday’s after-hours trading rose after the surgical robotics specialist reported fourth-quarter results that showed the procedure’s growing holdings and installed base were still expanding.
In the fourth quarter of 2025, Intuitive Surgical’s revenue is up 19% year-over-year to $2.9 billion. And the company’s net income rose to $795 million from $686 million in the year-ago quarter.
By almost every metric, the quarter was excellent. But can the business compound enough to justify what investors are paying for today’s growth stock?
Image source: Getty Images.
The lifeblood of Intuitive’s business is the volume of procedures performed with its minimally invasive robots. Process trends not only highlight the attractiveness of its products to surgeons and hospitals, but process growth also helps drive demand for the company’s lucrative recurring revenue lines: service revenue and equipment and supplies sales.
In Q4, Intuitive Surgical’s global procedures grew 18% year over year.
And process growth was not limited to one platform.
Fourth-quarter procedures using its flagship da Vinci platform grew 17% in the quarter, and ion procedures grew 44%.
That process increase translates into broad-based revenue gains. Equipment and accessories revenue increased 17% to $1.7 billion, and service revenue increased 19% to $422 million.
System sales were also impressive. Intuitive placed 532 Da Vinci systems in the quarter, and 303 of those were its latest Da Vinci 5 systems. In the full year, Intuitive’s installed base of da Vinci surgical systems grew 12% year-over-year to 11,106.
Ion — Intuitive Surgical’s robotic-assisted bronchoscopy system — is still a much smaller business than Da Vinci, but recent rapid growth in its process suggests it’s becoming more important to the company. Furthermore, the company ended 2025 with an active installed base of 995 Ion systems, a 24% year-over-year increase. This kind of growth from a system beyond its flagship da Vinci system shows how the company can expand its platform over time.
But it’s worth noting that Intuitive placed 42 Ion systems in Q4 — down from 69. Therefore, investors would like to hope that this trend reverses at some point. However, it is good news to see that utilization is still increasing (process growth increased even as ion system placements decreased). This suggests that the system is successful with its customers.
The company’s financial profile also helps explain the bull case for the stock. In 2025, its total revenue grew to $10.1 billion, an increase of about 21% from $8.4 billion in 2024. And equipment and goods and services revenue totaled $7.6 billion, or about 75% of total revenue – an important factor to keep in mind as this mix helps anchor a process for the business model. Additionally, this helps explain why there is a year-over-year decrease in ion system placements in the fourth quarter of 2025 compared to the fourth quarter of 2024.
Sahaja also has remarkable balance-sheet flexibility. The company reported nearly $9 billion in cash, cash equivalents, and investments at year-end 2025.
Debt? Intuitive Surgical has none.
But are the shares really worth their extremely high valuations? As of this writing, the stock trades at about 70 times earnings.
Additionally, management’s 2026 outlook indicates a slower growth rate than the company delivered for investors in 2025. Management guided for global process growth of 13% to 15% in 2026 — down from last year’s 18% growth. Of course, the company is notorious for providing conservative guidance. Still, a meaningful downturn (if one materializes) could be a cause for concern given the stock’s high valuation. With such a valuation, shares could take a big hit if process growth cools more than expected.
Ultimately, however, Intuitive Surgical’s fourth-quarter results strengthen the stock’s case as a good long-term investment, and it looks like the shares are a buy today, even at the high valuation. The company’s core platform is still expanding, and Ion is contributing well to the overall business.
Of course, the stock’s very high valuation makes it a high-risk investment, so investors should keep their positions in the stock small as part of their overall portfolio.
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Daniel Sparks and his clients have no positions in any stocks. The Motley Fool has articles and recommends Intuitive Surgical. Motley Fool has a disclosure policy.
This often overlooked growth stock recently reported an amazing quarter. Time to buy shares? Originally published by Motley Fool
