Boston Scientific — Income Statement, Cash Flows & Balance Sheet
Is Boston Scientific profitable?
Boston Scientific is growing rapidly and becoming significantly more profitable, with revenue up nearly 20% in 2025.
| Metric | 2023 | 2024 | 2025 | Change (2023–2025) |
|---|---|---|---|---|
| Net sales ($M) | $14,240 | $16,747 | $20,074 | +41% |
| Gross profit margin | 69.5% | 68.6% | 69.0% | ~flat |
| Operating income ($M) | $2,343 | $2,603 | $3,613 | +54% |
| Net income ($M) | $1,592 | $1,846 | $2,892 | +82% |
| Diluted EPS | $1.07 | $1.25 | $1.94 | +81% |
Revenue has grown by more than $5 billion in a single year, while net income and earnings per share have roughly doubled over two years. Gross margins have held steady despite rapid growth, suggesting the business scales well.
Several one-time charges partially offset the strong underlying performance.
| Item ($M) | 2023 | 2024 | 2025 |
|---|---|---|---|
| Intangible asset impairment | $58 | $386 | $46 |
| Litigation-related charges (credits) | $(111) | $— | $194 |
| Restructuring charges | $69 | $16 | $101 |
The 2024 impairment was unusually large — tied to acquisitions whose products were cannibalized by newer technology. In 2025, a $194 million litigation charge related to a legacy IP matter inflated costs. Stripping these out, the underlying business momentum is even stronger than the headline numbers suggest.
Where does Boston Scientific's revenue come from?
Cardiovascular is the growth engine, nearly doubling in three years and now representing about two-thirds of total revenue.
| Segment ($M) | 2023 | 2024 | 2025 | Change |
|---|---|---|---|---|
| MedSurg net sales | $5,422 | $5,993 | $6,824 | +26% |
| Cardiovascular net sales | $8,819 | $10,755 | $13,250 | +50% |
| Total net sales | $14,240 | $16,747 | $20,074 | +41% |
Within Cardiovascular, Electrophysiology (heart rhythm mapping and ablation) is the standout performer, growing from $800 million to $3.3 billion in just two years — largely driven by the Farapulse pulsed field ablation system. MedSurg is also growing solidly, led by Urology (boosted by the 2024 Axonics acquisition) and Endoscopy.
Both segments are highly profitable at the operating level, with Cardiovascular margins improving sharply.
| Segment operating income margin | 2023 | 2024 | 2025 |
|---|---|---|---|
| MedSurg | 34.5% | 34.6% | 33.2% |
| Cardiovascular | 26.7% | 29.8% | 32.4% |
Cardiovascular's margin has expanded by nearly six percentage points over two years, reflecting the leverage of scaling a high-growth product like Farapulse. MedSurg remains a steady, high-margin contributor. Note these are segment-level figures before corporate costs and amortization.
Does Boston Scientific generate cash?
Boston Scientific is a strong cash generator, with operating cash flow surging to over $4.5 billion in 2025.
| Cash flow metric ($M) | 2023 | 2024 | 2025 | Change |
|---|---|---|---|---|
| Operating cash flow | $2,503 | $3,435 | $4,534 | +81% |
| Capital expenditures | $(711) | $(790) | $(876) | — |
| Free cash flow (GAAP operating CF minus capex) | $1,792 | $2,645 | $3,658 | +104% |
Operating cash flow has grown even faster than net income, a healthy sign. Capital spending is rising but remains modest relative to revenue, leaving substantial free cash flow (cash left after maintaining and expanding the business).
Boston Scientific is deploying cash aggressively on acquisitions while also refinancing its debt.
| Activity ($M) | 2023 | 2024 | 2025 |
|---|---|---|---|
| Acquisitions paid | $(1,811) | $(4,640) | $(1,593) |
| Long-term debt proceeds | $— | $2,145 | $1,558 |
| Debt repayments | $— | $(504) | $(1,595) |
The company is clearly in acquisition mode, spending heavily to add new businesses — and borrowing to help fund it. Cash on hand jumped from $414 million to nearly $2 billion by year-end 2025, in part because the company pre-funded future activity with a new euro bond offering.
How strong is Boston Scientific's balance sheet?
Debt has risen meaningfully to fund acquisitions, but remains well within the company's own financial covenant limits.
| Debt metric ($M) | 2024 | 2025 | Change |
|---|---|---|---|
| Long-term debt | $8,968 | $11,137 | +$2,169 |
| Current debt obligations | $1,778 | $299 | -$1,479 |
| Total debt (approx.) | $10,746 | $11,436 | +$690 |
| Leverage ratio (actual) | — | 1.92x | vs. 4.50x limit |
Total debt has grown, but the actual leverage ratio of 1.92 times EBITDA sits comfortably below the maximum covenant threshold of 4.50 times. The dramatic drop in current (near-term) debt from $1.8 billion to $299 million means refinancing pressure in the next twelve months is minimal.
The balance sheet is dominated by goodwill and intangibles from years of acquisitions — a factor worth watching.
| Asset ($M) | 2024 | 2025 | Change |
|---|---|---|---|
| Goodwill | $17,089 | $18,282 | +$1,193 |
| Other intangible assets, net | $6,684 | $7,019 | +$335 |
| Total assets | $39,395 | $43,673 | +$4,278 |
Goodwill and intangibles together make up roughly 58% of total assets — typical for a medical device company that grows through acquisitions, but it means the balance sheet's strength depends heavily on those acquired businesses continuing to perform. The $386 million impairment charge taken in 2024 is a reminder that this can occasionally go the other way.