Why Intuitive Surgical's Strong Quarter Still Spooked Investors

Intuitive Surgical reported strong second-quarter results, with revenue up 19% and non-GAAP earnings per share up 28%. Investors focused on the company’s unchanged da Vinci procedure-growth guidance, which implies slower growth than in recent years. The stock’s premium valuation and technical breakdown could keep pressure on shares, even as analysts remain broadly bullish.

Intuitive Surgical was part of the artificial intelligence (AI)/robotics trade before it became mainstream. The company manufactures the da Vinci robotic surgical system, which has an installed base of over 11,700 systems as of June 30, 2026.

In the report, released after the market closed on July 16, the company delivered impressive numbers. Second quarter 2026 revenue of $2.89 billion increased 19%, compared with $2.44 billion in the second quarter of 2025. Second quarter 2026 non-GAAP net income attributable to Intuitive Surgical, Inc. was $1 billion, or $2.80 per diluted share, compared with $800 million, or $2.19 per diluted share, in the second quarter of 2025. The Company repurchased 0.9 million shares of its common stock for $380 million in the second quarter of 2026.

Despite the strong report, ISRG fell approximately 10% in after-hours trading. The headline reason is that the company didn’t raise its full-year guidance for da Vinci procedures. The company’s prior guidance was 13.5% to 15.5%, which would mark its slowest growth in several years.

To be fair, Intuitive Surgical is still posting impressive growth numbers for its da Vinci system. For the quarter just ended: Worldwide da Vinci procedures grew approximately 15% year over year (YOY). The company placed 468 da Vinci surgical systems, compared with 395 in the second quarter of 2025. The second quarter 2026 da Vinci surgical system placements included 246 da Vinci 5 systems, compared with 180 in the second quarter of 2025. The company grew its da Vinci surgical system installed base to 11,710 systems as of June 30, 2026, an increase of 12% YOY.

But it’s hard to overstate how important the da Vinci is to Intuitive Surgical’s growth. The system is a one-time purchase. But it spawns a host of services, instruments, and accessories that drive revenue and earnings.

To be fair, ISRG has been dropping since July 14. That’s when HCA Healthcare trimmed its full-year outlook, which implied fewer surgical procedures and sent all medical device stocks lower. That's not necessarily what Intuitive Surgical is reporting. It’s just reporting slower growth. Yet growth is still growth.

At the close of trading on July 16, Intuitive Surgical traded for around 46x forward earnings. That’s a premium to the S&P 500, but for investors new to ISRG, it’s a discount to prior price-to-earnings (P/E) ratios, which at one point in the last few years were around 60x. Nevertheless, ISRG is expensive at a time when investors are becoming more sensitive to the value they’re getting for the price.