Medline's $6.3B IPO Caps 2025 as Year's Biggest Debut
Medical supplies giant Medline raised $6.26 billion in the largest U.S. IPO since Rivian's 2021 offering, with shares jumping 41% on debut.
The IPO market saved its biggest deal for last.
Medline Industries, the medical supplies distributor backed by Blackstone, Carlyle, and Hellman & Friedman, priced its initial public offering at $29 per share on December 17, raising $6.26 billion. Shares opened at $35 and closed at $41—a 41% first-day pop that valued the company at roughly $54 billion.
It's the largest U.S. IPO since Rivian's $13.7 billion deal in November 2021.
The Business
Medline manufactures and distributes medical supplies to hospitals, surgery centers, and healthcare facilities across the U.S. The company operates 50 distribution centers and sells everything from gloves and gowns to medical devices and laboratory equipment.
Revenue reached $23.4 billion in fiscal 2024, up 8% from the prior year. Gross margins run around 22%, typical for medical distribution. The business generates consistent cash flow, a characteristic that appeals to institutional investors seeking stability.
The company has operated for over a century, founded in 1910 as a garment manufacturer before pivoting to medical products. Private equity firms acquired Medline in 2021 for $34 billion, making it one of the largest leveraged buyouts on record.
Why Now
The timing reflects both company-specific factors and broader market conditions.
Healthcare spending continues growing at 5-6% annually, driven by an aging population and expanded insurance coverage. Medline sits at the center of that spending, supplying the consumables hospitals use daily. Unlike pharmaceutical companies, which face patent cliffs and pricing pressure, medical distributors enjoy more predictable revenue streams.
The IPO market itself has recovered. Through December 18, 347 companies went public in 2025—up 55% from 2024. Aggregate proceeds exceeded $75 billion, an 80% increase from the prior year. Investors who sat on the sidelines in 2022-2023 have returned.
The Sponsor Exit
Private equity's ownership structure shaped the offering.
Blackstone, Carlyle, and Hellman & Friedman together own about 75% of Medline post-IPO. The firms didn't sell shares in the offering—all proceeds went to the company for debt paydown—but the public listing creates liquidity for future sales.
The sponsors paid $34 billion for Medline in 2021. At Friday's closing price of $43, their stake is worth roughly $40 billion, representing a solid return but not the blockbuster multiples PE firms achieved in the 2010s. Medical distribution is a lower-growth, lower-risk sector that generates reliable but not spectacular returns.
What the Pop Signals
A 41% first-day gain is unusual for a deal this size.
Typically, large IPOs price efficiently because institutional buyers have more leverage in negotiations. Medline's pop suggests underwriters left money on the table—or that demand exceeded expectations as investors sought exposure to defensive healthcare.
The broader signal is positive for 2026 IPO candidates. Strong aftermarket performance in late 2025 builds confidence among issuers and bankers. Several high-profile companies, including SpaceX, OpenAI, and Kraken, are reportedly considering public offerings next year.
The Risk Factors
Medline's prospectus highlights concentration risk. Ten customers account for 27% of revenue, and hospital consolidation could increase buyer power over time. Labor costs have risen across healthcare, squeezing margins.
The company also carries significant debt from its leveraged buyout. Net debt stood at approximately $8.5 billion prior to the IPO, though proceeds will reduce that burden.
Healthcare policy remains a wildcard. Medicare reimbursement rates, drug pricing legislation, and potential changes to hospital funding could all ripple through to suppliers like Medline.
The 2025 IPO Scorecard
Medline caps a strong year for new listings.
The number of IPOs increased 57% compared to 2024, and proceeds jumped 80%. Technology and healthcare led sector activity, with AI-related companies drawing particular interest. The third quarter was the busiest since 2021.
That momentum sets up 2026 as potentially the first truly "normal" IPO year since the pandemic. If rate cuts continue and equity markets hold, the pipeline of private companies seeking exits should deliver another active calendar.
Medline's successful debut suggests the window is open.