Buy or Sell Intuitive Surgical Stock?

September 4th, 2025 by Trefis Team
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ISRG: Intuitive Surgical logo
ISRG
Intuitive Surgical

Intuitive Surgical stock (NASDAQ: ISRG) has declined 16% year-to-date, significantly underperforming the S&P 500’s 10% gain. The stock faced additional pressure recently after management warned that potential tariffs could negatively impact its 2026 performance.

This raises the key question: Is ISRG a buy at under $450? We believe it is. While the stock’s very high valuation makes it sensitive to adverse events, we see minimal cause for concern with the company’s underlying business. Our conclusion is based on an analysis of Intuitive Surgical’s key metrics—including Growth, Profitability, and Financial Stability—which show that its operational performance and financial condition remain very strong.

That being said, if you seek an upside with less volatility than holding an individual stock, consider the High Quality Portfolio. It has comfortably outperformed its benchmark—a combination of the S&P 500, Russell, and S&P MidCap indexes—and has achieved returns exceeding 91% since its inception. Separately, see – GOOG Stock To $400?

How Does Intuitive Surgical’s Valuation Look vs. The S&P 500?

Going by what you pay per dollar of sales or profit, ISRG stock looks very expensive compared to the broader market.

  • Intuitive Surgical has a price-to-sales (P/S) ratio of 17.4 vs. a figure of 3.3 for the S&P 500
  • Additionally, the company’s price-to-free cash flow (P/FCF) ratio is 79.8 compared to 21.0 for S&P 500
  • And, it has a price-to-earnings (P/E) ratio of 61.0 vs. the benchmark’s 23.9

How Have Intuitive Surgical’s Revenues Grown Over Recent Years?

Intuitive Surgical’s Revenues have grown considerably over recent years.

  • Intuitive Surgical has seen its top line grow at an average rate of 15.4% over the last 3 years (vs. increase of 5.3% for S&P 500)
  • Its revenues have grown 20.8% from $7.6 Bil to $9.1 Bil in the last 12 months (vs. growth of 5.1% for S&P 500)
  • Also, its quarterly revenues grew 21.4% to $2.4 Bil in the most recent quarter from $2.0 Bil a year ago (vs. 6.1% improvement for S&P 500)

How Profitable Is Intuitive Surgical?

Intuitive Surgical’s profit margins are much higher than most companies in the Trefis coverage universe.

Does Intuitive Surgical Look Financially Stable?

Intuitive Surgical’s balance sheet looks very strong.

  • Intuitive Surgical is a debt free company.
  • Cash (including cash equivalents) makes up $5.3 Bil of the $20 Bil in Total Assets for Intuitive Surgical.  This yields a very strong Cash-to-Assets Ratio of 26.4% (vs. 7.2% for S&P 500)

How Resilient Is ISRG Stock During A Downturn?

ISRG stock has seen an impact that was slightly worse than the benchmark S&P 500 index during some of the recent downturns. Worried about the impact of a market crash on ISRG stock? Our dashboard ISRG Lost 5.9% In A Day. Do You Buy Or Wait? has a detailed analysis of how the stock performed during and after previous market crashes.

Inflation Shock (2022)

  • ISRG stock fell 49.9% from a high of $365.42 on 8 November 2021 to $183.06 on 14 October 2022, vs. a peak-to-trough decline of 25.4% for the S&P 500
  • The stock fully recovered to its pre-Crisis peak by 18 January 2024
  • Since then, the stock has increased to a high of $610.45 on 22 January 2025 and currently trades at around $440

Covid Pandemic (2020)

  • ISRG stock fell 40.5% from a high of $206.10 on 20 February 2020 to $122.58 on 23 March 2020, vs. a peak-to-trough decline of 33.9% for the S&P 500
  • The stock fully recovered to its pre-Crisis peak by 17 July 2020

Global Financial Crisis (2008)

  • ISRG stock fell 75.9% from a high of $39.32 on 10 April 2008 to $9.48 on 2 March 2009, vs. a peak-to-trough decline of 56.8% for the S&P 500
  • The stock fully recovered to its pre-Crisis peak by 1 March 2010

Putting All The Pieces Together: What It Means For ISRG Stock

In summary, Intuitive Surgical’s performance across the parameters detailed above are as follows:

• Growth: Very Strong
• Profitability: Very Strong
• Financial Stability: Very Strong
• Downturn Resilience: Moderate
• Overall: Very Strong

While Intuitive Surgical’s valuation is admittedly high, it is important to note that the stock has historically commanded a premium. For perspective, its average price-to-sales ratio over the last five years is 19.5, with an average P/E ratio of 75.

In our view, this premium is justified by several factors: improving revenue growth and margins, a near-monopoly position in the robotic surgery market, and a significant base of recurring revenue. For these reasons, we believe ISRG is a good stock to buy at its current levels.

The primary risk is that tariff concerns for 2026 could deter investors from paying an even higher multiple in the short term. However, for those with a 3-to-5-year investment horizon, we believe the company’s strong fundamentals make it a compelling opportunity.

Still, not too happy about the volatile nature of ISRG stock? The Trefis High Quality (HQ) Portfolio, with a collection of 30 stocks, has a track record of comfortably outperforming its benchmark that includes all 3 – the S&P 500, S&P mid-cap, and Russell 2000 indices. Why is that? As a group, HQ Portfolio stocks provided better returns with less risk versus the benchmark index; less of a roller-coaster ride, as evident in HQ Portfolio performance metrics.

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