Intuitive Surgical Inc. (NASDAQ:ISRG)

The financial information reveals a generally positive trend in profitability metrics over the five-year period. While some fluctuation exists, the company demonstrates increasing earnings across the measured indicators from 2021 to 2025. A notable pattern is the consistent relationship between Earnings Before Interest and Tax (EBIT) and Earnings Before Interest, Tax, Depreciation and Amortization (EBITDA), indicating that depreciation and amortization expenses remain relatively stable as a proportion of EBIT.

EBITDA Trend

EBITDA experienced a decrease from US$2,222.5 million in 2021 to US$1,999.2 million in 2022, representing a decline of approximately 10.9%. However, subsequent years show consistent growth, reaching US$2,413.7 million in 2023, US$3,173.5 million in 2024, and culminating in US$3,988.5 million in 2025. This represents an overall increase of approximately 79.5% from 2022 to 2025.

Relationship between EBT and EBITDA

The difference between Earnings Before Tax (EBT) and EBITDA is attributable to depreciation and amortization. The consistent difference between these figures across the years suggests a stable depreciation and amortization policy and asset base. The gap between EBT and EBITDA widens from approximately US$322.3 million in 2021 to US$635.2 million in 2025, mirroring the overall growth in EBITDA.

Net Income Correlation

Net income attributable to the company generally follows the trend of EBITDA and EBT. While net income decreased from 2021 to 2022, it subsequently increased, reaching US$2,856.0 million in 2025, indicating a strong correlation between operational profitability and bottom-line results. The increase in net income from 2021 to 2025 is approximately 67.7%.

In summary, the company experienced a period of initial decline in 2022, followed by robust growth in EBITDA, EBT, and net income through 2025. The consistent relationship between EBIT and EBITDA suggests a stable cost structure related to depreciation and amortization. The overall trend indicates improving financial performance over the analyzed period.

The Enterprise Value to EBITDA ratio exhibited fluctuating behavior over the five-year period. Initial values decreased, followed by increases, and then a final decrease. Enterprise Value and EBITDA both generally increased over the period, but at differing rates, influencing the ratio’s movement.

Enterprise Value (EV)

Enterprise Value decreased from US$98.02 billion in 2021 to US$81.89 billion in 2022, representing a decline of approximately 16.5%. It then increased significantly to US$128.12 billion in 2023 and further to US$200.05 billion in 2024. A subsequent decrease to US$164.25 billion was observed in 2025.

Earnings Before Interest, Tax, Depreciation, and Amortization (EBITDA)

EBITDA experienced a slight decrease from US$2.22 billion in 2021 to US$2.00 billion in 2022. Subsequent years showed consistent growth, reaching US$2.41 billion in 2023, US$3.17 billion in 2024, and US$3.99 billion in 2025.

EV/EBITDA Ratio

The EV/EBITDA ratio began at 44.10 in 2021 and decreased to 40.96 in 2022, coinciding with the decrease in Enterprise Value and a slight decrease in EBITDA. The ratio then increased substantially to 53.08 in 2023 and peaked at 63.04 in 2024, driven by a larger increase in Enterprise Value relative to EBITDA. Finally, the ratio decreased to 41.18 in 2025, as Enterprise Value declined while EBITDA continued to grow.

The most significant change occurred between 2023 and 2024, where the EV/EBITDA ratio increased by approximately 18.8%. The decrease in the ratio from 2024 to 2025 suggests a potential re-alignment between the company’s valuation and its operational earnings. The fluctuations in the ratio indicate a dynamic relationship between market perception of the company’s value and its underlying profitability.