Boston Scientific reported fourth-quarter revenue of $5.29 billion, surpassing the consensus forecast of $5.28 billion and its own guidance range of $5.22 billion to $5.31 billion. On an organic basis, sales grew 12.7 percent year-over-year, while adjusted earnings per share came in at $0.80, beating the consensus estimate of $0.78. The company achieved an adjusted gross margin of 70.7 percent and an operating margin of 27.3 percent, both broadly in line with management’s targets. Cardiovascular segment sales increased 18.2 percent reported (16.1 percent organic) to $3.48 billion, while the MedSurg segment delivered 11.7 percent reported growth to $1.81 billion.

Management guided to full-year 2026 organic revenue growth of 10 percent to 11 percent and adjusted EPS of $3.43 to $3.49, missing the consensus EPS forecast by one cent. For the first quarter, it projected organic sales growth of 8.5 percent to 10 percent and EPS of $0.78 to $0.80, compared with analyst estimates centered at $0.79. The conservative outlook prompted investors to reassess near-term momentum despite Boston Scientific’s track record of double-digit quarterly growth.

The company’s electrophysiology business, which represents roughly 17 percent of quarterly revenue, reported sales of $890 million, well below the consensus estimate of $933 million. Soft demand in the U.S. market contributed to the underperformance. While other segments such as Watchman left atrial appendage closure devices saw a 29 percent sales jump to $535 million, the electrophysiology miss raised concerns over execution in a key growth area.

Several analysts argued that the market reaction was overdone, pointing to a projected free cash flow of $4.2 billion in 2026 and 12 consecutive quarters of double-digit sales growth. They highlighted recent product approvals and clinical trial progress, including the FDA clearance for a pulsed field ablation catheter and ongoing enrollment in trials for next-generation mapping technologies. With a robust pipeline in cardiovascular, neuromodulation and endoscopy device platforms, bulls contend that long-term fundamentals remain intact.