Shares of Intuitive Surgical Inc. (ISRG), once a highly favored stock within the SIA S&P 500 Index Report, have seen a steady decline in relative performance rankings. After years of technical leadership, the stock began to underperform on a point and figure relative basis in early summer 2025. In late July, ISRG slipped below the 50% line into unfavored territory, as noted in the attached matrix chart. This technical breakdown has coincided with growing underperformance across all key timeframes, with the stock now down -13.79% year to date, -15.03% over the last quarter, and -4.28% in the last month. These losses stand in sharp contrast to the S&P 500 Index, which is up 11.06% year to date, 8.17% over the quarter, and 2.23% over the past month. While ISRG continues to benefit from a strong long-term outlook and leadership in robotic-assisted surgery, near-term concerns are building. Valuation remains a key issue. The stock trades at a premium to peers, reflecting high investor expectations. But such a premium leaves little room for disappointment if revenue slows or margins weaken. Competition is also intensifying. Medtronicâs Hugo system is gaining traction, pushing ISRG to move faster on innovation or adjust pricing to stay competitive. Internationally, capital constraints in some healthcare systems may delay purchases of its expensive surgical platforms, which could weigh on near-term sales. Costs are another growing pressure. Increased R&D and manufacturing investments may limit near-term operating leverage. At the same time, tariffs and inflation in labor, materials, and logistics are adding stress to margins. With these headwinds in place, precise execution is now more important than ever. ISRG must deliver consistent results, manage costs, and maintain its edge in surgical robotics to support its elevated valuation. Until those conditions improve, the stock may continue to struggle both technically and fundamentally.
The attached point and figure chart, scaled at 2%, presents a technically vulnerable setup for shares of ISRG. Key near-term support levels have been broken and now act as resistance. These levels are marked by red lines at the 3-box reversal of $484.15, followed by $567.26, and a higher resistance at $614.02. Any potential recovery would face these as technical barriers. On the support side, visible point and figure support is noted at $397.17, aligning closely with the psychological $400 level, which may attract near-term attention. A more significant longer-term support level appears at $359.73, a price last seen in September 2021, marking a possible structural reference point if further downside develops. A large pink oval on the chart highlights the 2022 decline, where shares moved from approximately $325 to $185. This area shows previous weakness in a similar technical context and is positioned near a long-term trend line located in the bottom right corner of the chart. Current price levels remain elevated relative to that trend reference. Additional chart signals include negative sector relative strength, indicated by the red box, and a low SIA SMAX score of 1 out of 10. The SMAX score reflects relative strength across a range of asset classes and suggests limited current leadership from ISRG within a broader asset context.
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