BSX · Q2 2026 Earnings

Bearish

Boston Scientific

Reported July 29, 2026

30-second summary

30-second take: Boston Scientific delivered Q2 revenue of $5.44B (+7.5% YoY reported, 7.0% organic) and adjusted EPS of $0.86, beating consensus by 1.3% and $0.03 respectively and landing at the high end of every Q2 guide component. That is the last piece of good news on the print. Management cut FY2026 reported revenue growth from 7.0–8.5% to 5.5–6.5% (a second consecutive ~175bps midpoint cut, ~500bps total from January), lowered FY adjusted EPS from $3.34–$3.41 to $3.28–$3.32, withdrew the +50–75bps operating margin expansion commitment, and guided Q3 to 3–5% reported growth — a step-down of ~250bps from Q2 and materially below the "slightly above 7%" H2 run-rate framed on the Q1 call.

Headline numbers

EPS

Q2 FY2026

$0.86

+3.6% vs est.

Revenue

Q2 FY2026

$5.44B

+7.5% YoY

+1.3% vs est.

Gross margin

Q2 FY2026

70.8%

Operating margin

Q2 FY2026

21.6%

Key financials

Q2 FY2026

Metric	Q2 FY2026	Q2 FY2025	YoY	Q1 FY2026	QoQ
Revenue	$5.44B	$5.06B	+7.5%	$5.20B	+4.6%
EPS	$0.86	$0.75	+14.7%	$0.80	+7.5%
Gross margin	70.8%	67.7%	+305bps	69.4%	+135bps
Operating margin	21.6%	16.2%	+545bps	21.2%	+45bps

Guidance

Guidance is issued for the full year only, refreshed each quarter. Prior and new below are the same FY updated this quarter.

Actuals vs prior guidance

Metric	Period	Prior guide	Actual	Δ	Result
Revenue growth (reported)	Q2 FY2026	5.5% to 7.5%	7.5%	+0.0pts above guide (at high end)	Beat
Revenue growth (organic)	Q2 FY2026	5.0% to 7.0%	7.0%	+0.0pts above guide (at high end)	Beat
Adjusted EPS	Q2 FY2026	$0.82 to $0.84	$0.86	+$0.02-0.04 above guide	Beat

New guidance

Metric	Period	Guide	YoY
Revenue growth (reported)	Q3 FY2026	3% to 5%	-2% to +2% YoY
Revenue growth (organic)	Q3 FY2026	3% to 5%	-2% to +2% YoY
Adjusted EPS	Q3 FY2026	$0.80 to $0.82	—

Changes to prior guidance

Metric	Period	Prior guide	New guide	Δ	Result
Revenue growth (reported)	FY2026	7.0% to 8.5%	5.5% to 6.5%	-1.5pts to -2.0pts (midpoint lowered from 7.75% to 6.0%)	Lowered
Revenue growth (organic)	FY2026	6.5% to 8.0%	5% to 6%	-1.5pts to -2.0pts (midpoint lowered from 7.25% to 5.5%)	Lowered
Adjusted EPS	FY2026	$3.34 to $3.41	$3.28 to $3.32	-$0.06 to -$0.09 (midpoint lowered from $3.375 to $3.30)	Lowered
Adjusted EPS growth YoY	FY2026	9% to 11%	Withdrawn — no replacement	—	Withdrawn
Adjusted operating margin expansion	FY2026	50 to 75 basis points	Withdrawn — no replacement	—	Withdrawn

Segment KPIs

Q2 FY2026

Segment	Q2 FY2026	Q2 FY2025	YoY
MedSurg	$1.818B	$1.716B	+5.9%
Cardiovascular	$3.624B	$3.345B	+8.3%
Endoscopy	$0.793B	$0.737B	+7.6%
Neuromodulation	$0.341B	$0.303B	+12.5%
MedSurg Organic Growth	5.4%	—	—
Cardiovascular Organic Growth	7.8%	—	—

Other KPIs

Q2 FY2026

Segment	Q2 FY2026	Q2 FY2025	YoY
United States	$3.426B	$3.224B	+6.3%
EMEA	$0.932B	$0.878B	+6.2%
Asia-Pacific	$0.878B	—	+11.2%
Latin America and Canada	$0.206B	—	+22.4%
Organic Net Sales Growth	7.0%	—	—
Adjusted EPS	$0.86	$0.75	—
GAAP EPS	$0.61	—	—
Gross Profit Margin	70.75%	—	—
Operating Income Margin	21.65%	—	—
Share Repurchase Program	~40 million shares	—	—

Management tone

Transcript unavailable for this quarter; tone analysis deferred. The guidance actions themselves carry the message: two consecutive FY cuts totaling ~500bps of reported revenue growth, withdrawal of the operating margin and EPS-growth commitments, and a Q3 guide that steps growth down another ~250bps versus Q2 all say what any prepared-remarks language would have softened. When the January guide is halved by July, and when the prior CFO framing of roughly 50bps of annual margin expansion is withdrawn two quarters later, the tonal shift is complete regardless of what verbatim was offered.

Answers to last quarter's watch list

Q2 organic growth landing within the 5.0–7.0% guide — Resolved positively on the narrow question, negatively on the broader read. Organic printed 7.0% at the top of the guide, meeting the "trough" framing. But the Q3 guide of 3–5% organic means Q2 was NOT the trough — Q3 is now guided ~200bps below Q2, and H2 is materially worse than the April "slightly above 7%" framing implied.

Resolved negatively

US EP quarterly growth direction — Not disclosed in the press release. The company did not break out US EP quarterly growth; segment-level Cardiovascular decelerated to +8.3% from +13.5%, consistent with continued EP pressure but not a direct answer.

Not resolved

Watchman standalone vs concomitant disclosure — Not disclosed on the print. Management did not quantify the standalone/concomitant mix in the press release. Per the framing rule flagged last quarter, the refusal to break out the split is itself a tell that the mix is not yet moving fast enough to be presented constructively.

Not resolved

Penumbra vote and H2 close timing — Not addressed in the press release; the FY2026 guide continues to exclude Penumbra contribution, and Q2 revenue of $5.44B does not appear to include any Penumbra revenue. Whether the H2 close path remains intact cannot be confirmed from the press release alone.

Continue monitoring

Gross margin trajectory — Resolved neutrally. Q2 GAAP gross margin printed 70.7% (adjusted 70.3%), roughly flat with Q1's 70.5% — stabilization rather than further deterioration. But adjusted operating margin printed 28.4% and management withdrew the FY operating margin expansion commitment. Gross margin holding does not offset the margin-expansion walk-back. Status: Resolved negatively (via the operating margin withdrawal)

Urology recovery framing at Q2 print — Urology printed +1.1% reported / +0.8% organic in Q2, essentially flat with the +1% Q1 organic framing and no evidence of inflection.

Resolved negatively

What to watch into next quarter

Q3 organic growth landing within the 3–5% guide — The new Q3 guide midpoint of 4% is ~300bps below Q2's 7.0% actual and ~350bps below Q1's 9.4%. A print at the low end (3%) would confirm the deceleration is still expanding and likely force a third FY cut; a print at the high end (5%) would suggest H2 stabilizes near the new FY implied range and Q3 is the true trough.

Whether operating margin expansion is re-committed for 2027 — The FY2026 +50–75bps expansion guide was withdrawn this quarter. Watch for any framing at Q3 or Investor Day that either reaffirms the "every year" cadence for 2027 or extends the walk-back. A refusal to re-commit would materially compress the LRP margin arithmetic.

Penumbra close and revenue contribution inclusion — H2 2026 close was the April framing. If the deal closes on the Q3 print, watch how much revenue is folded into the guide and whether the base FY organic guide holds; a delay would leave the 5.5–6.5% reported guide fully organic and even more exposed.

EMEA operational growth direction — Reported +6.1% is the first above-5% EMEA quarter in a while. Watch whether Q3 operational EMEA (stripping FX) sustains above 5%, which would resolve the structural weakness question, or reverts to the sub-5% band of the prior four quarters.

Cardiovascular growth stabilization — Cardiovascular reported growth has now decelerated from +18.2% (Q4) → +13.5% (Q1) → +8.3% (Q2). A Q3 print below +7% would suggest EP share loss is now dragging the composite franchise rather than being offset by Watchman, Interventional Cardiology, and Peripheral Interventions.

Q3 EPS versus the $0.80–$0.82 guide — Q3 midpoint of $0.81 is $0.05 below Q2's $0.86 print. A Q3 miss versus this guide would signal that the FY $3.28–$3.32 range itself is at risk and force a third guide cut in three quarters.

Sources

Boston Scientific Q2 2026 Earnings Release (SEC EDGAR): https://www.sec.gov/Archives/edgar/data/885725/000088572526000051/q22026earningsrelease.htm
Boston Scientific Q1 2026, Q4 2025, Q3 2025, and Q2 2025 earnings briefs (Tapebrief, internal — prior quarter references for guidance arc and watch-list resolution)

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