# Establishment Labs Holdings Inc. (ESTA) fundamentals

Data as of 2026-09-08. NASDAQ, United States. Sector: Healthcare / Health Care Technology. Price $74.29, market value $2.2 billion.

## Valuation
- **P/E (trailing): n/a** (negative earnings). Establishment Labs Holdings Inc. reported negative earnings over the last twelve months, so the P/E is not meaningful; use price-to-sales, EV/EBITDA and free-cash-flow yield instead.
- **Price / sales: 9.0×**. Each dollar of revenue is priced at 9.0×.
- **Price / book: 102.5×**. The shares trade at 102.5× book value; most of the value is in earnings power and intangibles rather than the balance sheet.
- **Free-cash-flow yield: -1.9%** (5-yr avg -5.5%). Free cash flow is negative: the business is consuming cash, which is normal for heavy investment phases but a warning otherwise.

## Profitability
- **Gross margin: 70.5%**. Establishment Labs Holdings Inc. keeps 70.5% of revenue after the direct cost of what it sells, the kind of margin that comes with software, brands or pricing power.
- **Operating margin: -7.6%**. Operating margin is negative: the business loses money before interest and tax.
- **Net margin: -24.2%**. The company reported a net loss over the last twelve months.
- **Return on equity: -216.9%**. Return on equity is negative because earnings are negative.
- **Return on invested capital: -7.6%**. Return on all capital, debt included, is -7.6%: close to or below the cost of capital, so growth may not create value.
- **Return on assets: -10.9%**. Each dollar of assets produces -10.9% of profit.

## Growth
- **Revenue growth (1 yr): 27.1%** (3-yr 9.3%/yr, 5-yr 20.0%/yr). Revenue grew 27.1% over the last year, against 20.0% a year compounded over five years: growth is accelerating.
- **EPS growth (1 yr): 42.7%**. Earnings per share rose 42.7%, faster than revenue, so margins expanded or the share count shrank.

## Financial health
- **Debt to equity: 10.51**. Debt is 10.51 times equity, a leveraged balance sheet that needs steady cash flow to service.
- **Altman Z-score: 4.30**. A Z-score of 4.30 places the company in the safe zone for bankruptcy risk.
- **Piotroski F-score: 4/9**. 4 of 9 checks pass: mixed.

## Dividends
- **Dividend: none**. Establishment Labs Holdings Inc. does not currently pay a dividend.

## Price and momentum
- **Total return (1 yr): 92.1%** (YTD 1.9%, 3-mo -0.0%). The shares are up 92.1% over twelve months including dividends.
- **From 52-week high: -23.9%** (103.4% above the low). Trading 24% below its 52-week high.
- **200-day average: above**. The price sits above its 200-day moving average, the usual definition of an uptrend.
- **RSI (14-day): 45**. An RSI of 45 is neutral.
- **Beta (1 yr): 1.38** (volatility 55%). Beta of 1.38 against the S&P 500: the shares move much more than the market.

Live score and charts: https://foliofundamentals.com/analyzer?s=ESTA · Page: https://foliofundamentals.com/stocks/esta

Not investment advice.