Executive Summary

Q4 2024 revenue was $18.534M, up 41% Y/Y, with gross margin at 88% (vs. 85% a year ago); net loss was $12.576M or $(0.40) per share .
Management initiated FY25 revenue guidance of $81–$85M (+24% to +30% Y/Y) and expects gross margins to “normalize to and remain in the mid to high 80% range” despite 35% China tariff headwinds .
Active accounts reached 529 at year-end (up from 504 in Q3), with product and subscription revenue growing 41% and 40% Y/Y, respectively, in Q4 .
Strategic pipeline catalysts: 510(k) submission for pediatric Clarity (late 2024), planned delirium submission in 2025 (Breakthrough Designation), and accelerated stroke algorithm development; management characterizes 2025 as “catalyst-heavy” .
Street consensus (S&P Global) data for Q4 2024 was unavailable at the time of this analysis due to API limits, so we cannot quantify beats/misses vs. estimates; we note management commentary suggested gross margin upside vs. prior indications despite tariff pressures .

What Went Well and What Went Wrong

What Went Well

41% Y/Y total revenue growth in Q4 to $18.534M, with gross margin improving to 88% (from 85%); product revenue +41% and subscription revenue +40% Y/Y, driven by new account wins and expansion in the installed base .
Commercial execution remained strong: active accounts reached 529 at year-end (+25 in Q4), with account launches “slightly ahead of expectations” despite a deliberate mid-December pause; Q4 cadence should approximate Q1 .
Management highlighted continued operating leverage drivers in manufacturing (automation, scale) supporting high gross margins; quote: “Gross margin for the fourth quarter of 2024 was 88%...reflecting continuation of our strategy of using automation to improve manufacturing efficiency and volume-based leverage” .

What Went Wrong

Operating expenses rose 49% Y/Y in Q4 to $29.122M (investments in sales force, headcount, and public company costs), widening the quarterly net loss to $12.576M from $8.274M a year ago .
Tariff headwinds: CFO noted the China-sourced component tariff rate increased to 35% (from 25% in 2024), an assumption embedded in 2025 gross margin outlook; contingency plans exist but represent a risk to margins if pressures intensify .
Near-term operating spend is set to rise further: R&D up 40%–60% Y/Y in 2025 and stock-based compensation ~+$15M for 2025, delaying profitability despite strong top-line growth .

Financial Results

Headline P&L and Margins

Metric	Q4 2023	Q3 2024	Q4 2024
Revenue ($USD Millions)	$13.131	$17.195	$18.534
Gross Profit ($USD Millions)	$11.116	$15.011	$16.238
Gross Margin (%)	85%	87%	88%
Total Operating Expenses ($USD Millions)	$19.497	$24.948	$29.122
Net Loss ($USD Millions)	$(8.274)	$(10.417)	$(12.576)
Diluted EPS (GAAP)	$(1.53)	$(1.85)	$(0.40)

Notes: GAAP figures; company did not present non-GAAP EPS in the 8-K or call .

Segment Revenue Breakdown

Segment Revenue	Q4 2023	Q3 2024	Q4 2024
Product Revenue ($USD Millions)	$10.007	$13.321	$14.147
Subscription Revenue ($USD Millions)	$3.124	$3.874	$4.387

KPIs and Balance Sheet

KPI / Metric	Q4 2023	Q3 2024	Q4 2024
Active Accounts (period end)	n/a	504	529
Cash & Cash Equivalents ($USD Millions)	$34.495	$14.110	$194.370

Context: Q4 cash reflects ~+$188M net IPO proceeds in October 2024; year-end cash was $194.4M .

Guidance Changes

Metric	Period	Previous Guidance	Current Guidance	Change
Total Revenue	FY 2025	n/a	$81–$85M	Initiated
Gross Margin	FY 2025	n/a	Mid–high 80% range (assumes 35% tariff)	Initiated
R&D Expense Growth	FY 2025	n/a	+40%–60% Y/Y	Initiated
Stock-based Compensation	FY 2025	n/a	≈$15M	Initiated

Note: Q3 2024 guidance covered FY2024 revenue only ($64.2–$64.7M); FY2025 guidance was first introduced with Q4 results .

Earnings Call Themes & Trends

Topic	Previous Mentions (Q-2: Q2’24)	Previous Mentions (Q-1: Q3’24)	Current Period (Q4’24)	Trend
AI/Technology initiatives (Clarity, pediatrics, delirium, stroke)	n/a	Emphasized pipeline beyond seizures; delirium Breakthrough; stroke work initiated	Pediatric 510(k) submitted; delirium filing planned 2025; stroke data collection accelerated (>200 patients)	Increasing focus/catalyst density
Supply chain & tariffs	n/a	Noted gross margin strength; limited detail on tariffs	Assumes 35% China tariff in 2025 vs. 25% in 2024; contingency planning in place	Headwind intensifying but managed
Commercial execution & utilization	n/a	504 active accounts; +25 adds; strategy to avoid late-Dec launches; focus on utilization and new accounts	529 active accounts; +25 in Q4; Q4 ≈ Q1 cadence; headband purchasing normalized after unusually strong Q3	Sustained momentum
VA ATO / federal channel	n/a	VA ATO received; ~200 VA hospitals “license to hunt”; near-term impact limited	Dedicated sales leader; growing interest; updates expected ahead	Early but promising
R&D investment & profitability path	n/a	IPO proceeds to fund growth; path to cash flow breakeven with cash on hand	R&D +40–60% Y/Y; ~$15M SBC; cash balance supports breakeven objective	Heavier near-term spend

Management Commentary

CEO framing: “2024 was a transformative year for Ceribell…we advanced our mission to become the standard of care for seizure management…meaningfully expanded adoption…cement our position as the category leader through clinical innovation and data generation” .
Commercial footprint: “Our active account set at 529…we intend to continue targeting the approximately 5,500 remaining prospective accounts…on track to expand our account acquisition team to 55 territory managers by mid-2025” .
Pipeline catalysts: “We submitted a 510(k) application for pediatric Clarity…preparing to submit [delirium] application to FDA later this year…accelerated investment in stroke detection algorithm; collected data on over 200 patients” .
Margin framework: “Gross margins to normalize and remain in the mid to high 80% range…accounts for the current 35% tariff on materials sourced from China, up from 25% in 2024” .
Investment posture: “We expect stock-based compensation to contribute approximately $15 million to operating expenses for the full year 2025…we remain committed to our goal of achieving cash flow breakeven with cash on hand” .

Q&A Highlights

Guidance cadence: 2025 growth expected roughly consistent with 2024 as hiring and ramping of TMs are designed to accelerate growth in 2026; modest seasonal volume lift in Q4/Q1 vs. summer months .
Account adds and Q1 setup: Shut down late-December launches to preserve quality, pulling some Q1 launches into Q4; Q4 should approximate Q1 for launches .
Gross margin/Tariffs: GM outlook embeds 35% tariffs on China-sourced materials; contingency plans exist to mitigate if needed .
OpEx visibility: R&D +40%–60% Y/Y in 2025; SBC ~+$15M; commercial headcount tracking to 55 TMs by mid-2025; reps typically contribute after 12–18 months (more impact 2026) .
Utilization dynamics: Upward trajectory in usage per account continues, though quarterly purchasing can be lumpy and Q4/Q1 benefit from seasonal ICU census .
VA channel: Dedicated focus; building interest post-ATO; more tangible updates expected next quarter .

Estimates Context

We attempted to retrieve S&P Global consensus (revenue and EPS) for Q4 2024 but were unable to access the data due to an API request limit at the time of analysis. As a result, we cannot quantify beats/misses vs. Street for Q4 2024 at this time. If desired, we can refresh and append a vs.-consensus table once S&P Global data access is restored.

Additional Q4 2024 Press Releases and Prior-Quarter Context

Q4 period press: Ceribell highlighted five abstracts at the 2024 Neurocritical Care Society meeting linking its point-of-care EEG and Clarity to shorter hospital stays and improved outcomes; Clarity remains first and only device FDA 510(k)-cleared for diagnosing electrographic status epilepticus .
Q3 2024 reported revenue was $17.195M (+48% Y/Y), gross margin 87%, active accounts 504; FY2024 revenue guidance was $64.2–$64.7M at that time .
We did not locate Q2 2024 earnings documents in this corpus; trend analysis is anchored on Q3 and Q4 2024 [List range returned none].

Key Takeaways for Investors

Durable growth with high gross margins: Q4 revenue +41% Y/Y and gross margin at 88% underscore attractive unit economics supported by automation and scale .
Near-term investment cycle: Elevated OpEx (R&D +40%–60% Y/Y; SBC ~$15M) positions the company for TAM expansion but delays profitability; management still targets cash flow breakeven with current cash .
2025 setup conservative by design: FY25 revenue guide $81–$85M anticipates hiring ramp and tariff headwinds; acceleration expected in 2026 as new reps mature .
Pipeline catalysts can re-rate the story: Pediatric Clarity 510(k), delirium submission (Breakthrough), and stroke algorithm development expand indications and could unlock additional utilization vectors .
Execution focus: Continued account adds (529 at year-end) and utilization growth, plus VA channel opening, support sustained top-line momentum with potential upside as federal deployments scale .
Tariff/supply-chain risk is real but managed: GM guidance already bakes in 35% tariffs; contingency plans in place mitigate downside risk to margins .

Appendix: Narrative Drivers of Quarterly Change

Q4 > Q3 sequential dynamics: Revenue rose to $18.534M from $17.195M; management cited stronger-than-expected launches (pulled forward) and normalization of purchasing patterns after an unusually strong Q3 .
Y/Y mix strength: Both product ($14.147M vs. $10.007M) and subscription ($4.387M vs. $3.124M) contributed; gross margin expanded 300 bps to 88% on automation and volume leverage .
Operating expense step-up: Sales & marketing and G&A increases reflect public company transition and commercial buildout; net loss widened as investments outpaced revenue growth .

All figures and quotations are sourced from Ceribell’s Q4 2024 8‑K/press release and earnings call transcript, and prior-quarter filings and transcripts, as cited throughout.

Ceribell, Inc. (CBLL)·Q4 2024 Earnings Summary