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ESTAEstablishment Labs Holdings Inc.
$91.04$2.7B
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  4. Financial Ratios

Establishment Labs Holdings Inc. (ESTA) Financial Ratios

Latest Ratios: P/E Ratio -52.9x · EV/EBITDA N/A · ROE -133.3%. (2016–2025 historical series)

Income StatementBalance SheetCash FlowRatios
AnnualQuarterly

ESTA Valuation Multiples

Price-based multiples — how expensive the stock is relative to earnings, sales, book value, and cash flow

MetricTTMFY 2025FY 2024FY 2023FY 2022FY 2021FY 2020FY 2019FY 2018FY 2017FY 2016
Market Cap$2.7B$2.2B$1.3B$663M$1.6B$1.6B$878M$568M$476M——
Enterprise Value$2.9B$2.3B$1.4B$815M$1.7B$1.6B$846M$579M$445M——
P/E Ratio →-52.93——————————
P/S Ratio12.6710.237.814.019.9312.7910.366.347.77——
P/B Ratio114.5391.6824.4436.03—31.9311.7114.346.85——
P/FCF———————————
P/OCF———————————

P/E links to full P/E history page with 30-year chart

ESTA EV Ratios

Enterprise-value multiples — capital-structure-neutral measures of total business value

MetricTTMFY 2025FY 2024FY 2023FY 2022FY 2021FY 2020FY 2019FY 2018FY 2017FY 2016
EV / Revenue—11.128.634.9310.6312.809.996.467.28——
EV / EBITDA———————————
EV / EBIT———————————
EV / FCF———————————

ESTA Profitability

Margins and return-on-capital ratios measuring operating efficiency

Margins

Full margin charts and quarterly trend are on the Earnings History page

MetricTTMFY 2025FY 2024FY 2023FY 2022FY 2021FY 2020FY 2019FY 2018FY 2017FY 2016
Gross Margin69.3%69.3%66.0%64.8%65.9%67.4%62.0%61.3%59.0%51.0%51.0%
Operating Margin-18.5%-18.5%-30.1%-39.4%-24.5%-19.8%-33.0%-34.5%-39.0%-57.6%-80.0%
Net Profit Margin-24.2%-24.2%-51.0%-47.5%-46.5%-32.5%-45.0%-42.6%-34.5%-100.6%-111.9%

Return on Capital

MetricTTMFY 2025FY 2024FY 2023FY 2022FY 2021FY 2020FY 2019FY 2018FY 2017FY 2016
ROE-133.3%-133.3%-236.7%-1537.7%-353.5%-65.5%-66.5%-69.9%-65.4%——
ROA-14.5%-14.5%-27.5%-32.7%-42.9%-27.8%-27.9%-32.7%-24.3%-80.5%-75.0%
ROIC-14.6%-14.6%-20.9%-35.4%-38.0%-39.9%-44.9%-51.8%-75.6%-154.1%-105.7%
ROCE-14.1%-14.1%-20.4%-33.9%-28.4%-21.1%-24.9%-32.0%-47.8%——

ESTA Leverage & Debt

Solvency and debt-coverage ratios — lower is generally safer

MetricTTMFY 2025FY 2024FY 2023FY 2022FY 2021FY 2020FY 2019FY 2018FY 2017FY 2016
Debt / Equity11.2311.234.2410.45—1.070.701.220.32——
Debt / EBITDA———————————
Net Debt / Equity—8.022.548.27—0.02-0.430.27-0.44——
Net Debt / EBITDA———————————
Debt / FCF———————————
Interest Coverage-1.30-1.30-3.06-4.11-5.19-3.38-3.06-3.31-1.37-2.34-5.45

ESTA Liquidity & Efficiency

Short-term solvency ratios and asset-utilisation metrics

MetricTTMFY 2025FY 2024FY 2023FY 2022FY 2021FY 2020FY 2019FY 2018FY 2017FY 2016
Current Ratio3.043.043.563.063.853.555.114.126.050.690.23
Quick Ratio2.002.002.411.672.912.664.212.894.540.460.14
Cash Ratio0.920.921.320.701.701.683.261.623.200.190.01
Asset Turnover—0.590.480.610.770.910.540.770.530.610.67
Inventory Turnover0.760.760.720.731.511.451.391.211.011.292.02
Days Sales Outstanding—134.01142.90103.6979.9670.4182.4592.78105.24137.96122.55

ESTA Shareholder Yields

Earnings, FCF, buyback, and dividend yields — total returns to shareholders

Dividends

Full dividend history and growth charts are on the Dividend History page

MetricTTMFY 2025FY 2024FY 2023FY 2022FY 2021FY 2020FY 2019FY 2018FY 2017FY 2016
Dividend Yield———————————
Payout Ratio———————————

Total Shareholder Return Metrics

MetricTTMFY 2025FY 2024FY 2023FY 2022FY 2021FY 2020FY 2019FY 2018FY 2017FY 2016
Earnings Yield———————————
FCF Yield———————————
Buyback Yield0.0%0.0%0.0%0.0%0.0%0.0%0.0%0.0%0.0%——
Total Shareholder Yield0.0%0.0%0.0%0.0%0.0%0.0%0.0%0.0%0.0%——
Shares Outstanding—$30M$28M$26M$24M$24M$23M$21M$17M$18M$18M

Key Metrics

Growth RegimeExpanding
ProfitabilityNegative
Balance SheetVulnerable
Cash FlowBurning
Top Statement Risk

US Regulatory Approval Delay

Verified Source

Metrics are mathematically derived from official filings.

SEC 10-K (2026Q1)

Success Premium Drives Valuation Multiples

Based on current market data, ESTA trades at a price-to-sales ratio of 12.30, a valuation that appears to bake in significant optimism regarding future US market entry rather than reflecting the company's current international-only revenue base or its persistent lack of GAAP profitability.

The elevated P/S multiple suggests that investors are pricing the stock as a high-growth med-tech disruptor rather than a traditional medical device manufacturer. This valuation warrants caution, as any delay in FDA approval could trigger a sharp re-rating toward the lower multiples observed in international-only peers.

Negative Returns Reflect Capital Intensity

According to historical financial data, the company's ROIC has remained consistently negative, bottoming at -9.8% in 2023Q4 and showing only marginal improvement to -6.0% in 2026Q1, which indicates that the firm is currently destroying rather than compounding shareholder capital during its expansion phase.

The persistent negative ROIC is a direct consequence of high fixed-cost investments in manufacturing and R&D that have yet to be offset by sufficient operating scale. Investors should monitor whether the company can achieve a positive return on capital once the US market is unlocked, as current trends suggest the business model is not yet self-sustaining.

Working Capital Cycles Remain Stretched

As reported in recent quarterly filings, the cash conversion cycle remains elevated at 340 days in 2026Q1, a figure that highlights significant inefficiencies in inventory management and suggests that the company's capital is heavily tied up in slow-moving stock across its global distribution network.

The high DIO of 442 days suggests that the complexity of managing a vast array of implant sizes and shapes is creating a drag on liquidity. This inefficiency implies that the company may struggle to optimize its cash position until it achieves the volume density required to streamline its supply chain.

Liquidity Buffer Faces Ongoing Pressure

Based on the 2026Q1 balance sheet, the quick ratio of 1.91 provides a moderate cushion, yet the company's reliance on external financing to cover persistent operating losses suggests that its liquidity position remains vulnerable to any unexpected disruptions in capital market access.

While the current ratio of 2.96 appears healthy on the surface, the underlying cash burn necessitates a careful watch on the company's ability to maintain its runway. The lack of positive free cash flow means that liquidity is essentially a function of the company's ability to raise capital rather than its operational success.

Misapplication of Revenue Growth Metrics

Market participants frequently over-rely on top-line revenue growth as a proxy for business health, which obscures the reality that ESTA's growth is currently funded by equity dilution and debt rather than organic cash generation from its core aesthetic implant operations.

Investors should prioritize free cash flow margins and the path to operating break-even over headline revenue growth. Focusing on revenue alone ignores the high cost of customer acquisition and the potential for margin compression if the company is forced to increase marketing spend to defend its international market share.

Download Financial Ratios Data

Includes 30+ ratios · 10 years · Updated daily

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ESTA — Frequently Asked Questions

Quick answers to the most common questions about buying ESTA stock.

What is Establishment Labs Holdings Inc.'s P/E ratio?

Establishment Labs Holdings Inc.'s current P/E ratio is -52.9x. This places it at the 50th percentile of its historical range.

What is Establishment Labs Holdings Inc.'s ROE?

Establishment Labs Holdings Inc.'s return on equity (ROE) is -133.3%. The historical average is -141.5%.

Is ESTA stock overvalued?

Based on historical data, Establishment Labs Holdings Inc. is trading at a P/E of -52.9x. This is at the 50th percentile of its historical P/E range. Compare with industry peers and growth rates for a complete picture.

What are Establishment Labs Holdings Inc.'s profit margins?

Establishment Labs Holdings Inc. has 69.3% gross margin and -18.5% operating margin.