Executive Summary

Q1 2025 revenue was $22.5m (+20% YoY; +21% constant currency) and EPS was -$0.36; results beat S&P Global consensus modestly on both revenue ($22.5m vs $22.0m*) and EPS (-$0.36 vs -$0.40*) as international strength (notably China) offset a moderated U.S. growth rate .
Management reaffirmed FY25 guidance: revenue $96–$98m, gross margin ~74%, and OpEx $133–$135m (incl. ~$22m SBC); mix-driven gross margin compression in Q1 (73%) was in line with plan and expected to improve in H2 with higher U.S. mix and scale .
International revenue grew 39% YoY (43% cc), with China demand and distributor stocking front-loading first-half growth; U.S. revenue grew 11% YoY but is expected to re-accelerate in H2 as Acquire-Test-Treat initiatives (LungTraX Detect/Connect, therapy awareness specialists, DTP) flow through the funnel .
Risk/catalyst setup: DOJ declined to intervene in the False Claims Act case (de-risking headline risk) and Pulmonx extended the term loan interest-only period to Oct-2027 (liquidity flexibility); H2 U.S. re-acceleration and LungTraX adoption are the key positive catalysts, while tariffs/FX and China order timing are watch items .

What Went Well and What Went Wrong

What Went Well
- International outperformance: OUS revenue +39% YoY (43% cc) to $8.3m, driven by strong China demand and distributor stocking; Europe also strong .
- Commercial execution and footprint: 10 new U.S. accounts added; 285 active U.S. accounts; management sees early traction from LungTraX Detect and peer-to-peer education (40+ P2P events; new CME modules) .
- De-risking and balance sheet flexibility: DOJ declined to intervene in the FCA/AKS matter; term loan interest-only extended to Oct-2027, preserving liquidity .
- Quote: “We are off to a strong start in 2025 as we continue to advance our Acquire, Test, and Treat strategy…” — CEO Steve Williamson .
What Went Wrong
- Mix-pressured gross margin: GM 73% vs 75% a year ago (and 74% in Q4), driven by outsized OUS mix; expected to improve in H2 with mix/scale .
- U.S. growth moderated: U.S. revenue +11% YoY to $14.2m; management cited tough comps and a need to better connect identified patients to treaters; expects Q1 to be a low point with H2 re-acceleration .
- Losses continue and cash burn seasonality: Net loss widened YoY to -$14.4m (EPS -$0.36); cash, cash equivalents & marketable securities declined to $88.7m, with Q1 the most cash-intensive quarter (bonus timing) .

Financial Results

Metric	Q3 2024	Q4 2024	Q1 2025
Revenue ($USD Millions)	$20.387	$23.765	$22.538
Gross Margin %	74%	74%	73%
Total Operating Expenses ($USD Millions)	$29.155	$31.007	$30.905
Net Loss ($USD Millions)	$(14.144)	$(13.175)	$(14.448)
Diluted EPS ($)	$(0.36)	$(0.33)	$(0.36)

Q1 vs S&P Global consensus

Metric	Actual Q1 2025	Consensus (S&P)	Surprise
Revenue ($USD Millions)	$22.538	$22.03*	+$0.51m / +2.3%
EPS ($)	$(0.36)	$(0.40)*	+$0.04

Values retrieved from S&P Global.*

Segment revenue

Segment	Q3 2024	Q4 2024	Q1 2025
U.S. Revenue ($USD Millions)	$13.836 (YoY +16.9%)	$15.879 (YoY +15.7%)	$14.221 (YoY +10.5%)
International Revenue ($USD Millions)	$6.551 (YoY +12.4%)	$7.886 (YoY +41.9%)	$8.317 (YoY +39.0%; +42.6% cc)

KPIs and cash

KPI	Q3 2024	Q4 2024	Q1 2025
Adjusted EBITDA Loss ($USD Millions)	$(8.115)	$(7.523)	$(8.506)
Cash, Cash Equivalents & Marketable Securities ($USD Millions)	$107.8	$101.5	$88.7
New U.S. Accounts Added (in quarter)	15	11	10
Active U.S. Accounts (period-end)	—	283	285

Notes: Adjusted EBITDA excludes SBC and other items per company reconciliation .

Guidance Changes

Metric	Period	Previous Guidance (2/19/25)	Current Guidance (4/30/25)	Change
Revenue	FY 2025	$96–$98m	$96–$98m	Maintained
Gross Margin	FY 2025	~74%	~74%	Maintained
Total Operating Expenses	FY 2025	$133–$135m (incl. ~$22m SBC)	$133–$135m (incl. ~$22m SBC)	Maintained

Management reiterated H2 gross margin improvement on mix/scale and discipline on OpEx while funding growth initiatives .

Earnings Call Themes & Trends

Topic	Previous Mentions (Q3’24, Q4’24)	Current Period (Q1’25)	Trend
LungTraX (Detect/Connect; AI-driven workflow)	Pilot launched; early technical success; plan to broaden in 1H25	Early active centers show ~15% emphysema detection; “several dozen” contracts in process; expanding installs through 2025	Accelerating adoption
U.S. growth cadence	Expect H2’25 U.S. re-acceleration as pilots scale; Q3 seasonality variable	Q1 likely a low point; initiatives (therapy awareness, DTP, LungTraX) to drive H2 acceleration	Near-term trough; H2 inflection targeted
China/tariffs/FX	OUS robust; new China distributor; monitoring FX; typical OUS seasonality	OUS beat aided by China stocking (approx. a quarter’s inventory); watching tariffs/FX; expect continued Q2 buys	Strong but policy-sensitive
Gross margin drivers	FY25 ~74% with H2 improvement (mix/scale/cost)	Q1 73% on OUS mix; reiterates ~74% FY with H2 lift	In line with plan
R&D/indications (AeriSeal; Japan PMS)	AeriSeal CONVERT II enrolling; OUS launch ~2026, U.S. ~2027; Japan PMS underway	Same timelines, enrollment ramping; expanding TAM by ~20% with AeriSeal	On track
Regulatory/legal	—	DOJ declined to intervene in FCA/AKS case; CID concluded	De-risked headline

Management Commentary

Strategic focus: “We are off to a strong start in 2025 as we continue to advance our Acquire, Test, and Treat strategy to broaden patient access to Zephyr Valves.” — Steve Williamson, CEO .
International mix and China: “Strength in international revenue was particularly pronounced due to stronger-than-expected results in China… coupled with greater-than-expected distributor stocking.” — Mehul Joshi, CFO .
U.S. growth path: “We anticipated this plateau… expect Q1 to represent a low point of U.S. growth… positioning us to return to consistent, sustainable long-term U.S. growth.” — Steve Williamson .
Liquidity and flexibility: “We successfully extended the interest-only period on our $37 million term loan… with a full principal payment due in October 2027.” — Mehul Joshi .

Q&A Highlights

Why not raise guidance after Q1 beat? Management reaffirmed $96–$98m as macro/tariff/FX uncertainties remain; upside could come from U.S. initiatives (LungTraX, therapy awareness specialists, DTP) as they scale into H2 .
China/stocking dynamics: Distributor likely purchased about a quarter’s worth of inventory in Q1; continued Q2 purchases expected; tariffs not embedded in guidance; regional breakout to be provided in the 10-Q segment note .
U.S. growth and comps: U.S. came in light vs some models due to tough comps rather than weather/flu; focus on connecting DTP-identified patients to treaters and on hospital lung health programs capturing ~15% emphysema detection from CTs .
Gross margin bridge: FY ~74% reiterated; H2 improvement on mix (higher U.S.), production scale, and cost optimization; near-term tariff effects seen as nominal given U.S. manufacturing and inventory position .

Estimates Context

Q1 2025: Revenue $22.54m vs $22.03m consensus*; EPS -$0.36 vs -$0.40 consensus* — modest beat on both lines .
FY 2025 consensus sits below company guidance (Rev ~$89.6m* vs guide $96–$98m), implying potential upward revisions if H2 U.S. acceleration materializes; watch for adjustments to incorporate OUS strength (with China pull-forward risk) and H2 mix/gross margin trajectory .
Values retrieved from S&P Global.*

Consensus snapshot

Period	Revenue Consensus Mean	EPS Consensus Mean
Q1 2025	$22.03m*	-$0.40*
FY 2025	$89.60m*	-$1.46*

Key Takeaways for Investors

Modest Q1 beat with high-quality revenue growth (OUS-led) and reaffirmed FY guide reduces near-term estimate risk; setup is for H2 U.S. re-acceleration as commercial initiatives flow through .
International outperformance was aided by China stocking; expect normalization/seasonality later in the year — monitor tariff/FX developments and order timing to assess sustainability .
H2 gross margin tailwind (mix/scale/cost) should offset Q1 OUS-mix pressure; track U.S. mix and production scaling to gauge margin recovery to ~74% for FY25 .
LungTraX (Detect/Connect) and therapy awareness specialists are the pivotal U.S. demand-conversion drivers; contract wins, active sites, and referral-to-treatment conversion metrics are the key leading indicators .
Legal overhang eased (DOJ non-intervention) and loan IO extension to Oct-2027 support focus on execution; liquidity of $88.7m is adequate to pursue breakeven path per management .
Consensus appears below guidance; if H2 U.S. acceleration materializes, upward estimate revisions are likely — but investors should adjust for potential first-half China pull-forward and macro/tariff risks .
Near-term trading implication: shares may be sensitive to incremental data points on U.S. procedure growth (summer/fall), LungTraX commercial scaling, and any tariff headlines impacting OUS order cadence .

Other Relevant Q1 2025 Press Releases

Company announced participation at the Goldman Sachs 46th Annual Global Healthcare Conference (May 28, 2025), indicating continued investor outreach .
Earnings date press release issued on April 16, 2025 .

Citations:

Q1 2025 8-K earnings press release and financial statements:
Q1 2025 earnings call transcript (prepared remarks and Q&A):
Q4 2024 8-K and call for prior-quarter context and initial FY25 guidance:
Q3 2024 8-K for two-quarters-back trend:

S&P Global consensus values are marked with an asterisk and were retrieved from S&P Global.*

Pulmonx Corp (LUNG)·Q1 2025 Earnings Summary