Establishment Labs Holdings (ESTA) has just posted Q1 2026 results with revenue of US$59.9 million and a basic EPS loss of US$0.45, alongside trailing 12 month revenue of US$229.6 million and an EPS loss of US$1.47. Over recent quarters, the company has seen quarterly revenue move from US$41.4 million in Q1 2025 to US$59.9 million in Q1 2026. Basic EPS has ranged from a loss of US$1.19 in Q4 2024 to a loss of US$0.45 in the latest quarter, setting up a results season where investors are closely watching how quickly margins can narrow those ongoing losses.

See our full analysis for Establishment Labs Holdings.

With the headline numbers on the table, the next step is to see how this earnings profile lines up with the prevailing growth and profitability narratives that investors have been using to frame Establishment Labs Holdings.

Losses Still Heavy At US$13.4 Million

• Net income for Q1 2026 was a loss of US$13.4 million on revenue of US$59.9 million, while the trailing 12 month loss sits at US$43.7 million on US$229.6 million of revenue.
• Bears focus on these losses, arguing that trailing 12 month net losses of US$43.7 million and a five year trend of losses growing about 12.4% per year keep profitability risk front and center for anyone looking at the stock.
  • The latest basic EPS loss of US$0.45 and trailing 12 month EPS loss of US$1.47 both underline that earnings are still firmly negative even as revenue has reached US$229.6 million over the same period.
  • With Q1 2026 revenue of US$59.9 million following US$64.6 million in Q4 2025, critics highlight that a premium valuation is currently being supported by a business that is not yet generating positive earnings.

Skeptics argue that persistent losses and rich sales multiples leave little room for disappointment if growth or margins slip, so it is worth seeing how their full case stacks up against these numbers 🐻 Establishment Labs Holdings Bear Case.

Premium P/S Of 9.2x Sets A High Bar

• The stock trades on a P/S of 9.2x compared with 2.8x for the US Medical Equipment industry and 1.5x for peers, even though the company remains loss making on both a quarterly and trailing 12 month basis.
• Consensus narrative highlights that the current share price of US$72.03 sits below the analyst target of US$89.89 and below a DCF fair value estimate of US$84.45, which some investors see as room for upside against that premium sales multiple.
  • Analysts’ target of US$89.89 implies a higher valuation than today’s US$72.03, while the DCF fair value of US$84.45 sits between the two, illustrating how different methods still point above the current share price even with a P/S of 9.2x.
  • At the same time, the company is unprofitable on a trailing 12 month basis with a net loss of US$43.7 million, so the rich P/S ratio is being supported by expectations rather than current earnings.

Forecast 96.8% Earnings Growth Faces Tough Starting Point

• Earnings are forecast to grow 96.82% per year with revenue projected to rise 18.6% per year, yet the trailing 12 month figures still show a loss of US$43.7 million and EPS loss of US$1.47, so that expected improvement is coming off a clearly loss making base.
• Bullish investors point to this forecast path to profitability within three years as a key part of the story, and the recent progression from a quarterly EPS loss of US$1.19 in Q4 2024 to US$0.45 in Q1 2026 is seen as early evidence that earnings can move closer to break even.
  • Across the last six reported quarters, quarterly revenue has moved from US$41.4 million in Q1 2025 to US$59.9 million in Q1 2026, while quarterly net losses have ranged between US$34.5 million and US$2.6 million, giving bulls specific data points to support the idea that scale may help future margins.
  • Supporters also emphasize that revenue is forecast to grow faster than the 11.4% US market benchmark at 18.6% annually, which they see as consistent with the higher P/S multiple if the projected 96.82% annual earnings improvement and eventual profitability are achieved.

Supporters argue that if revenue and earnings follow this steeper path, today’s losses could look like a staging phase rather than a red flag, so it can be useful to read the full bullish case built around these growth forecasts 🐂 Establishment Labs Holdings Bull Case

Next Steps

To see how these results tie into long-term growth, risks, and valuation, check out the full range of community narratives for Establishment Labs Holdings on Simply Wall St. Add the company to your watchlist or portfolio so you'll be alerted when the story evolves.

With bulls and bears both making strong cases around the same set of numbers, it makes sense to check the data yourself and decide how convincing each side really is. To weigh up both the upside and the concerns in one place, start by reviewing the 3 key rewards and 1 important warning sign.

See What Else Is Out There

Establishment Labs Holdings combines a substantial trailing 12 month loss of US$43.7 million with a relatively high 9.2x P/S multiple and ongoing negative EPS.

If you are uneasy about paying a premium for a loss making stock, it is worth checking out 51 high quality undervalued stocks to find companies priced with more modest expectations.

This article by Simply Wall St is general in nature. We provide commentary based on historical data and analyst forecasts only using an unbiased methodology and our articles are not intended to be financial advice. It does not constitute a recommendation to buy or sell any stock, and does not take account of your objectives, or your financial situation. We aim to bring you long-term focused analysis driven by fundamental data. Note that our analysis may not factor in the latest price-sensitive company announcements or qualitative material. Simply Wall St has no position in any stocks mentioned.