Establishment Labs Holdings Inc. (ESTA) carries a Roarable Rating of E (Strong Sell) with 30/100 RQD Confidence due to weak cash-flow efficiency and sensitivity to current interest rates. Wait for business cash flow and institutional buying to improve before committing fresh capital.
As of 2026-11-02, Establishment Labs Holdings Inc. (NASDAQ: ESTA) is rated E (Strong Sell / SELL) by Roarable's 5-pillar RQD engine with a composite confidence score of 30/100 at a spot price of $62.46 (-8.70% 1D, market cap $2.04B). Pillar breakdown: Fundamental Cash Engine 5/20, Institutional 13F & Options Flow 11/20, Executive Insider Alignment 8/20, FRED Macro Regime Fit 3/20, and SEC Balance-Sheet Forensics 3/20. Active quantitative signal LIQUIDITY_TAILWIND (BEARISH, conviction undefined/100) notes: undefined.
Within the Health Care sector (Industrial Specialties), ESTA carries a Roarable E (30/100 RQD), trailing P/E of N/A, gross margin of 69.3%, and ROIC of -15.8%. By comparison, CDRE (Cadre Holdings Inc.) holds a C grade (62/100 RQD, P/E 30.2x, ROIC 11.0%, cap $1.33B) and ENOV (Enovis Corporation) posts a D grade (44/100 RQD, P/E N/A, ROIC -32.7%, cap $1.32B). Among the 5-stock peer group, MSA leads on earnings multiple (24.8x) while MSA leads on capital efficiency (16.6% ROIC).
Per ESTA's SEC EDGAR XBRL 10-K filing (FY2025, filed 2025-12-31, CIK 0001688757), Establishment Labs Holdings Inc. generated $211.1M in revenue (+27.1% YoY), -$51.1M in net income, and -$56.9M in free cash flow against $357.2M in total assets and $247.5M in total debt. Key quantitative strengths: Established market leader in Health Care with deep daily trading liquidity.. Primary risk factors monitored: Company executives have done more routine share selling than personal cash buying lately.. Institutional options positioning shows a 50% call / 50% put premium split.
Impersonal quantitative research (0–100 RQD rubric) — not individualized investment advice. Past performance does not guarantee future results. Full Disclaimer
20D Institutional Volume Accumulation (±12.5% realized swing band)
Altman Z-Score 2.52 (WATCH ZONE (1.8–3.0)) • Piotroski F-Score 5/9
Dilution Drag (+2.48% YoY Shares) & executive Form 4 sales trim 16 pts from alignment
While ESTA currently carries a cautious 30/100 (E) rating due to Insider Conviction & Share Dilution (4/20), shorts face asymmetric squeeze risk if free cash flow inflects or management executes accretive buybacks.
Established market leader in Health Care with deep daily trading liquidity.
Options & Short-Covering Gamma: Reclaiming the 50-day SMA ($66.98) and Max Pain ($65.58) forces dealer call-delta covering toward $102.47.
Forensic Repair Trigger: Halting share dilution (Dilution Drag (+2.48% YoY Shares)) or retiring high-cost debt immediately upgrades the SEC 10-K Forensic pillar.
Establishment Labs Holdings Inc. (ESTA) dropped -8.70% to $62.46, trading at 31% of its 52-week range ($47 – $97.59). Stretched risk/reward at current multiples (-16% return on capital) under elevated 10-year interest-rate pressure.
Yahoo! Finance Canada report covering Establishment Labs Holdings Inc. (ESTA) market action, institutional positioning, and fundamental catalysts.
Yahoo Finance report covering Establishment Labs Holdings Inc. (ESTA) market action, institutional positioning, and fundamental catalysts.
Investing.com report covering Establishment Labs Holdings Inc. (ESTA) market action, institutional positioning, and fundamental catalysts.
TradingView report covering Establishment Labs Holdings Inc. (ESTA) market action, institutional positioning, and fundamental catalysts.
Simply Wall St report covering Establishment Labs Holdings Inc. (ESTA) market action, institutional positioning, and fundamental catalysts.
Investing.com report covering Establishment Labs Holdings Inc. (ESTA) market action, institutional positioning, and fundamental catalysts.
Yahoo Finance report covering Establishment Labs Holdings Inc. (ESTA) market action, institutional positioning, and fundamental catalysts.
Simply Wall St report covering Establishment Labs Holdings Inc. (ESTA) market action, institutional positioning, and fundamental catalysts.
Moby summary of Establishment Labs Holdings Inc.'s Q3 2026 earnings call
BTIG analyst Sam Eiber maintains Establishment Labs Hldgs (NASDAQ:ESTA) with a Buy and lowers the price target from $103 to $93.
Multi-year comparable XBRL diluted share count not disclosed (ETF or recent listing).
vs. +27.1% actual YoY revenue growth (assuming 9.25% cost of equity & 16.5x terminal multiple).
No active Ellis Vennor swing setup published on ESTA today. View full Setup Ledger →
No direct multi-tier Butterfly edges indexed yet for ESTA. Explore sector supply chains on /butterfly.
Across 1016 tracked Health Care securities in the Roarable RQD universe, Establishment Labs Holdings Inc. (ESTA) ranks #838 by composite RQD confidence (30/100, grade E) and #259 by equity capitalization ($2.04B). Within this direct 5-issuer industry benchmark cohort, MSA leads on earnings valuation at 24.8x trailing P/E, while MSA leads on capital efficiency and profitability with 16.6% ROIC and 46.5% gross margin. MSA currently holds the highest overall quantitative score in the immediate peer group at 72/100 (B) compared with ESTA at 30/100 (E).
| Ticker / Company | Roarable Grade | RQD Score | Trailing P/E | Gross Margin | ROIC | 1D Change | Market Cap | Head-to-Head |
|---|---|---|---|---|---|---|---|---|
| ESTA
ACTIVE
Establishment Labs Holdings Inc. | E | 30/100 | — | 69.3% | -15.8% | -8.70% | $2.04B | Benchmark Subject |
| CDRE Cadre Holdings Inc. | C | 62/100 | 30.2x | 42.5% | 11.0% | -2.38% | $1.33B | /cdre-vs-esta → |
| ENOV Enovis Corporation | D | 44/100 | — | 59.8% | -32.7% | -12.71% | $1.32B | /enov-vs-esta → |
| AVR Anteris Technologies Global Corp. | E | 23/100 | — | 70.3% | -35.0% | -1.71% | $625.9M | /avr-vs-esta → |
| MSA MSA Safety Incorporated | B | 72/100 | 24.8x | 46.5% | 16.6% | -0.33% | $6.91B | /msa-vs-esta → |
In its most recent audited fiscal period (FY2025, filed 2025-12-31), Establishment Labs Holdings Inc. (ESTA) reported GAAP revenue of $211.1M (+27.1% vs. FY2024 revenue of $166.0M , and +27.8% cumulative change since FY2023) , GAAP net income of -$51.1M, operating cash flow of -$50.9M, and free cash flow of -$56.9M (+11.9% YoY). On the balance sheet, ESTA closed FY2025 with $357.2M in total assets against $247.5M in total debt (Altman Z-Score: 2.52, Piotroski F-Score: 5/9).
| Fiscal Period | Filing Date | Revenue | Net Income | Operating Cash Flow | Free Cash Flow | Total Assets | Total Debt |
|---|---|---|---|---|---|---|---|
| FY2025 (FY) | 2025-12-31 | $211.1M | -$51.1M | -$50.9M | -$56.9M | $357.2M | $247.5M |
| FY2024 (FY) | 2024-12-31 | $166.0M | -$84.6M | -$58.5M | -$64.6M | $346.8M | $219.6M |
| FY2023 (FY) | 2023-12-31 | $165.2M | -$78.5M | -$88.5M | -$88.5M | — | — |
As of 2026-11-02, Establishment Labs Holdings Inc. (NASDAQ: ESTA) is rated E (Strong Sell / SELL) by Roarable's 5-pillar RQD engine with a composite confidence score of 30/100 at a spot price of $62.46 (-8.70% 1D, market cap $2.04B). Pillar breakdown: Fundamental Cash Engine 5/20, Institutional 13F & Options Flow 11/20, Executive Insider Alignment 8/20, FRED Macro Regime Fit 3/20, and SEC Balance-Sheet Forensics 3/20. Active quantitative signal LIQUIDITY_TAILWIND (BEARISH, conviction undefined/100) notes: undefined.
Within the Health Care sector (Industrial Specialties), ESTA carries a Roarable E (30/100 RQD), trailing P/E of N/A, gross margin of 69.3%, and ROIC of -15.8%. By comparison, CDRE (Cadre Holdings Inc.) holds a C grade (62/100 RQD, P/E 30.2x, ROIC 11.0%, cap $1.33B) and ENOV (Enovis Corporation) posts a D grade (44/100 RQD, P/E N/A, ROIC -32.7%, cap $1.32B). Among the 5-stock peer group, MSA leads on earnings multiple (24.8x) while MSA leads on capital efficiency (16.6% ROIC).
Per ESTA's SEC EDGAR XBRL 10-K filing (FY2025, filed 2025-12-31, CIK 0001688757), Establishment Labs Holdings Inc. generated $211.1M in revenue (+27.1% YoY), -$51.1M in net income, and -$56.9M in free cash flow against $357.2M in total assets and $247.5M in total debt. Key quantitative strengths: Established market leader in Health Care with deep daily trading liquidity.. Primary risk factors monitored: Company executives have done more routine share selling than personal cash buying lately.. Institutional options positioning shows a 50% call / 50% put premium split.
ESTA last traded at $62.46 (-8.70% on volume of 1,033,162 shares), positioning the stock -6.75% below its 50-day simple moving average ($66.98) and -13.73% below its 200-day simple moving average ($72.40). Across its 52-week range of $47.00 to $97.59, ESTA sits at the 30.6% percentile with a 14-day RSI of 56.0 (BULLISH MOMENTUM) and an implied next-earnings move of ±12.5% ($54.65 to $70.27).
Why ESTA Stock dropped -8.70% Today — RQD Quant Desk Flash. Stretched risk/reward at current multiples (-16% return on capital) under elevated 10-year interest-rate pressure.
Per the Roarable RQD rating, ESTA carries an RQD Score of 30 with a letter grade of E, labeled "Roarable Strong Sell — Forensic Risk / Avoid." The score is the sum of five pillars, each scored out of 20:
Taken together, the valuation tradeoff is that the market cap of $2.04B is supported largely by positioning and growth narrative rather than cash earnings. Upside drivers would require sustained revenue growth converting into improved operating margins and positive FCF. The 2nd-order risk is that a liquidity-sensitive stock with negative FCF and elevated leverage is vulnerable to funding-cost tightening. This is an analytical framing, not personalized advice.
| Period | Revenue | Operating Income | Net Income | EPS | FCF | Cash | Debt |
|---|---|---|---|---|---|---|---|
| FY 2025 | $211.1M | $-39.0M | $-51.1M | N/A | $-56.9M | $75.6M | $247.5M |
| FY 2024 | $166.0M | $-50.0M | $-84.6M | N/A | $-64.6M | $90.3M | $219.6M |
| FY 2023 | $165.2M | $-65.0M | $-78.5M | N/A | $-88.5M | N/A | N/A |
Per the SEC financials, revenue grew from $165.2M in FY 2023 to $211.1M in FY 2025 while operating losses narrowed from $-65.0M to $-39.0M. Per the market data, operating margin is -18.5% and net margin is -24.2%. ROIC is -15.8% per the market data. Per the Roarable RQD rating, the Altman Z-Score is 2.52 and the Piotroski F-Score is 5/9. Debt of $247.5M exceeds cash of $75.6M in FY 2025, and the rating reports Debt/Equity of 8.5.
Per the recent news section, catalysts include an FDA clearance headline described as an expanded clearance, a price target reduction to $93 by BTIG on estimates, and a Mizuho rating reiteration citing strong sales. Several items are flagged YELLOW (market wire), and one GREEN catalyst item relates to the FDA clearance. Per the Butterfly graph, the proprietary LIQUIDITY_TAILWIND signal is BEARISH with severity 80 and a Macro Tailwind Score of 30/100, driven by a 1.88x True Net Liquidity elasticity and a Net Liquidity reading of $5,745.73B with a -0.64% 4-week rate of change. Risk watch items are the bearish liquidity signal and the BTIG target reduction.
Real-time company headlines, analyst actions, and sector developments for Establishment Labs Holdings Inc. (ESTA) • Click "Debate This Headline" to argue it in the Roar Pit below
Yahoo! Finance Canada report covering Establishment Labs Holdings Inc. (ESTA) market action, institutional positioning, and fundamental catalysts.
Yahoo Finance report covering Establishment Labs Holdings Inc. (ESTA) market action, institutional positioning, and fundamental catalysts.
Investing.com report covering Establishment Labs Holdings Inc. (ESTA) market action, institutional positioning, and fundamental catalysts.
TradingView report covering Establishment Labs Holdings Inc. (ESTA) market action, institutional positioning, and fundamental catalysts.
Simply Wall St report covering Establishment Labs Holdings Inc. (ESTA) market action, institutional positioning, and fundamental catalysts.
Investing.com report covering Establishment Labs Holdings Inc. (ESTA) market action, institutional positioning, and fundamental catalysts.
Yahoo Finance report covering Establishment Labs Holdings Inc. (ESTA) market action, institutional positioning, and fundamental catalysts.
Simply Wall St report covering Establishment Labs Holdings Inc. (ESTA) market action, institutional positioning, and fundamental catalysts.
Welcome to the ESTA (Establishment Labs Holdings Inc.) Roar Pit. Current RQD Composite is 30/100 (Roarable Strong Sell — Forensic Risk / Avoid) in Industrial Specialties. Bulls point to operating leverage and sector positioning, while bears focus on macro rate sensitivity and margin execution. Pick your side (🐂 Bull or 🐻 Bear) and drop your price target below.
Everyone in here is repeating the bull case on ESTA, but look at what you are paying: current EV/EBITDA multiples with 69.3% gross margins. Unless Establishment Labs Holdings Inc. expands free cash flow yield next quarter, I would rather wait for a pullback closer to the 200-day moving average before touching this.
Looking at the 5-pillar RQD breakdown on ESTA, the market is fixating on short-term headline noise in Industrial Specialties and ignoring the balance sheet and cash flow trajectory. At $68.41 (52-wk range $47.00 - $97.59), any beat on forward guidance forces shorts and underweight funds to chase.
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