Report date: Wednesday, July 29, 2026, before the market opens
Conference call: 8:00 a.m. ET
Reference period: Quarter ended June 30, 2026
This report is less about whether Boston Scientific beats Q2 consensus by a few cents and more about whether management can stop the downward revision cycle.
The stock has already undergone a severe reset as growth expectations for WATCHMAN, electrophysiology and Urology deteriorated. At the July 28 close of $46.07, BSX was down approximately 51% from January 2, versus an 8% gain for SPY and a roughly 15% decline for the iShares U.S. Medical Devices ETF over the same period. At the current 2026 EPS consensus, the shares trade at approximately 13.8x forward earnings.
That valuation leaves room for a recovery, but only if investors can gain confidence that:
| Metric | Company’s Q2 guidance | Current Street expectation | What matters |
|---|---|---|---|
| Reported revenue growth | 5.5%–7.5% | Approximately 6%–7% | The midpoint implies revenue near $5.39B |
| Implied revenue | $5.34B–$5.44B | Approximately $5.39B | A beat without constructive guidance may not be enough |
| Organic growth | 5.0%–7.0% | Near the lower end of guidance | Mix among WATCHMAN, EP and the rest of the portfolio is critical |
| Adjusted EPS | $0.82–$0.84 | $0.83 | Roughly 11% year-over-year growth at consensus |
| FY26 organic growth | 6.5%–8.0% | — | Maintaining the range is necessary; the midpoint may be difficult to defend |
| FY26 adjusted EPS | $3.34–$3.41 | Approximately $3.35 | Consensus sits close to the bottom of the range |
Boston Scientific’s Q2 guidance implies reported sales of roughly $5.34 billion to $5.44 billion, based on Q2 2025 revenue of $5.061 billion. Published consensus estimates cluster around $5.39 billion and $0.83 of adjusted EPS. (sec.gov)
WATCHMAN is likely to be the most important topic on the call.
In Q1, WATCHMAN grew 19% organically, but that was below management’s expectations. The company attributed the slowdown to weaker stand-alone procedures, hospital-capacity and workflow constraints, reimbursement dynamics, and a shift toward concomitant procedures performed alongside AF ablations. Management reduced its full-year outlook to mid-teens global WATCHMAN growth and low-to-mid-teens U.S. growth. Boston Scientific nevertheless continues to view CHAMPION-AF data, physician education and longer-term expansion of concomitant use as supports for the franchise. (sec.gov)
The problem is that conditions apparently weakened after the Q1 call. At the May 27 Bernstein conference, CEO Mike Mahoney said declining stand-alone WATCHMAN use would likely produce flat sequential WATCHMAN revenue in both Q2 and Q3, despite growth in concomitant procedures. (earningscalls.dev)
A satisfactory update would include:
The biggest downside risk would be management indicating that WATCHMAN remains below the May framework or that flat sequential revenue could persist beyond Q3.
Boston Scientific’s electrophysiology business grew 22% organically in Q1, including 18% in the U.S. and 30% internationally. However, management acknowledged greater-than-expected PFA share loss as Medtronic, Johnson & Johnson and Abbott expanded their competitive footprints.
As a result, BSX lowered its 2026 global EP growth expectation to approximately 10%, including mid-single-digit U.S. growth and more than 20% international growth. The implied outlook after Q1 was only mid-to-high-single-digit global growth for the rest of 2026 and roughly flat to low-single-digit U.S. growth.
A strong absolute EP growth number may not satisfy investors if it still implies substantial share loss. Conversely, even modest evidence of U.S. stabilization could be meaningful given the stock’s reset.
Urology was the weakest major business in Q1, growing only 0.5% organically. Management cited problems in stone management, China volume-based procurement, product gaps and commercial disruption in sacral neuromodulation following the Axonics integration. Q1 organic growth across the other MedSurg businesses was substantially better: Endoscopy grew 6.8% and Neuromodulation 15.4%. (news.bostonscientific.com)
Management expected Urology to improve through the year but reduced its full-year outlook to low-to-mid-single-digit growth. Nearly 100 sales and clinical representatives had been hired or were in training at the time of the Q1 call, while products such as Asurys, LithoVue Elite, eCoin and a planned slim ureteroscope were expected to help the franchise.
For Q2, investors should look for:
Another roughly flat quarter would raise questions about whether the issue is more structural than a temporary commercial disruption.
Q1 adjusted gross margin was 70.5%, down approximately 100 basis points year over year, reflecting tariffs, POLARx discontinuation costs, weaker product mix and supply-chain investments. Management nevertheless maintained its target for 50–75 basis points of full-year adjusted operating-margin expansion, while expecting adjusted gross margin to finish slightly below 2025.
Two days before earnings, Boston Scientific disclosed a new global restructuring program covering supply-chain optimization, manufacturing transfers, functional transformation and organizational changes. The program is expected to run through 2029, involve some headcount reductions, generate $700–800 million of pre-tax charges, require $600–700 million of cash outlays, and eventually reduce gross annual pre-tax expenses by approximately $500 million. Management explicitly said a substantial portion of the savings would be reinvested in growth initiatives. (sec.gov)
Investors should not automatically capitalize the entire $500 million as incremental earnings. The call needs to establish:
Positive interpretation: BSX is using its scale to protect margins and fund its pipeline after a revenue-growth reset.
Negative interpretation: The program confirms that management now expects structurally slower growth and needs significant cost action to preserve double-digit adjusted EPS growth.
At the Q1 report, management cut 2026 organic revenue guidance to 6.5%–8.0% and adjusted EPS guidance to $3.34–$3.41, despite retaining the target for 50–75 basis points of operating-margin expansion. Q1 itself was solid—9.4% organic growth and $0.80 of adjusted EPS—but management identified WATCHMAN, EP and Urology as the three major reasons for the weaker outlook. (sec.gov)
The Street’s approximately $3.35 full-year EPS estimate is already near the bottom of management’s range. That suggests expectations are subdued, but it also means a reduction in the low end would likely be read as another credibility setback. (barchart.com)
| Outcome | Likely interpretation |
|---|---|
| Reiterates revenue and EPS ranges; Q2 near midpoint | Acceptable, but management commentary will determine the reaction |
| Reiterates ranges and signals WATCHMAN/EP stabilization | Clearly positive; could support a substantial relief rally |
| Narrows guidance toward the lower half | Mixed to negative, although much may already be reflected in the stock |
| Cuts organic growth but protects EPS through restructuring/buybacks | Negative for business quality, less negative for near-term EPS |
| Cuts both organic growth and EPS | Strongly negative; suggests the reset is not complete |
The upper half of the organic-growth range appears demanding unless Urology improves and the rest of the portfolio offsets flat sequential WATCHMAN and muted U.S. EP growth. The more realistic positive outcome may be guidance retention with improving confidence in the lower half, rather than a near-term return to BSX’s former double-digit organic-growth profile.
Boston Scientific entered a $2 billion accelerated share-repurchase agreement in May, initially receiving approximately 30.4 million shares and estimating a $0.02 benefit to 2026 adjusted EPS. The company retained another $3 billion of repurchase authorization following completion of that program. (news.bostonscientific.com)
The report should clarify the final share count, the Q2 weighted-average diluted share impact and whether the $0.02 benefit is already incorporated into updated guidance. Investors should distinguish underlying operating performance from EPS support created by a lower share count.
Penumbra shareholders approved the proposed acquisition on May 6. In the latest located transaction filing, closing remained subject to U.S. and international regulatory conditions. Investors will want an updated closing timetable, financing details and confirmation that Boston Scientific still expects the transaction to strengthen its vascular portfolio without compromising leverage or additional capital returns. (sec.gov)
Although the challenged businesses will dominate the discussion, BSX still has several offsets:
These businesses do not eliminate the near-term WATCHMAN and EP risks, but they matter when assessing whether BSX’s slowdown is companywide or concentrated in a few franchises.
The bar for the reported quarter is low: approximately $5.39 billion of revenue and $0.83 of adjusted EPS, both near the center of company guidance. A modest beat is therefore possible.
But the stock is unlikely to be driven primarily by the Q2 headline numbers. The decisive issues are whether WATCHMAN has stopped deteriorating, whether FARAPULSE share loss is moderating, whether Urology is recovering and whether management can maintain full-year guidance without relying excessively on cost cuts and buybacks.
The bullish setup is that expectations, valuation and sentiment have already reset dramatically, while the broader portfolio remains healthy. Stable guidance plus credible evidence of franchise stabilization could produce a meaningful relief rally.
The bearish setup is that the restructuring announcement precedes another reduction in revenue expectations, confirming that the slowdown extends beyond temporary workflow and commercial issues.
Overall, this is a credibility and stabilization quarter—not a conventional beat-or-miss quarter.