medp-20260331

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

___________________________________________

FORM 10-Q

___________________________________________

(Mark One)


x			QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the quarterly period ended March 31, 2026


o			TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the transition period from to .

Commission file number: 001-37856

___________________________________________

Medpace Holdings, Inc.

(Exact name of registrant as specified in its charter)

___________________________________________


Delaware			32-0434904
(State or other jurisdiction of incorporation or organization)			(I.R.S. Employer Identification No.)

5375 Medpace Way, Cincinnati, OH 45227

(Address of principal executive offices) (Zip Code)

(513) 579-9911

(Registrant’s telephone number, including area code)

Securities registered pursuant to Section 12(b) of the Act:


Title of each class	Trading Symbol(s)	Name of each exchange on which registered
Common Stock $0.01 par value	MEDP	NASDAQ Global Select Market

Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days. Yes x No o

Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit such files). Yes x No o

Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company, or an emerging growth company. See the definitions of “large accelerated filer”, “accelerated filer”, “smaller reporting company” and “emerging growth company” in Rule 12b-2 of the Exchange Act.


Large accelerated filer	x	Accelerated filer	o
Non-accelerated filer	o	Smaller reporting company	o
Emerging growth company	o

If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. o

Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act). Yes o No x

Indicate the number of shares outstanding of each of the issuer’s classes of Common Stock, as of the latest practicable date.


Class						Number of Shares Outstanding
Common Stock $0.01 par value						28,559,689 shares outstanding as of April 17, 2026


Item Number		Page
	PART I — FINANCIAL INFORMATION	3
Item 1.	Financial Statements (unaudited)	3
	Condensed Consolidated Balance Sheets as of March 31, 202 6 and December 31, 202 5	3
	Condensed Consolidated Statements of Operations for the three months ended March 31, 202 6 and 202 5	4
	Condensed Consolidated Statements of Comprehensive Income for the three months ended March 31, 202 6 and 20 25	5
	Condensed Consolidated Statements of Shareholders’ Equity for the three months ended March 31, 202 6 and 202 5	6
	Condensed Consolidated Statements of Cash Flows for the three months ended March 31, 202 6 and 202 5	7
	Notes to Condensed Consolidated Financial Statements	8
Item 2.	Management’s Discussion and Analysis of Financial Condition and Results of Operations	18
Item 3.	Quantitative and Qualitative Disclosures About Market Risk	24
Item 4.	Controls and Procedures	24

	PART II — OTHER INFORMATION	25
Item 1.	Legal Proceedings	25
Item 1A.	Risk Factors	25
Item 2.	Unregistered Sales of Equity Securities and Use of Proceeds	25
Item 3.	Defaults Upon Senior Securities	25
Item 4.	Mine Safety Disclosures	25
Item 5.	Other Information	25
Item 6.	Exhibits	25
	EXHIBIT INDEX	26
	SIGNATURES	27


(Amounts in thousands, except share amounts)	As of
	March 31, 2026		December 31, 2025
ASSETS
Current assets:
Cash and cash equivalents	$	652,681	$	497,049
Accounts receivable and unbilled, net (includes $3.1 million and $3.5 million with related parties at March 31, 2026 and December 31, 2025, respectively)	394,581		402,078
Prepaid expenses and other current assets	91,793		90,497
Total current assets	1,139,055		989,624
Property and equipment, net	136,548		131,055
Operating lease right-of-use assets	126,812		117,815
Goodwill	662,396		662,396
Intangible assets, net	33,265		33,420
Deferred income taxes	3,220		19,223
Other assets	28,317		21,939
Total assets	$	2,129,613	$	1,975,472
LIABILITIES AND SHAREHOLDERS’ EQUITY
Current liabilities:
Accounts payable (includes $0.2 million and $0.3 million with related parties at March 31, 2026 and December 31, 2025, respectively)	$	34,429	$	28,142
Accrued expenses	406,059		408,382
Advanced billings (includes $13.7 million and $12.3 million with related parties at March 31, 2026 and December 31, 2025, respectively)	856,344		854,390
Other current liabilities	48,182		52,834
Total current liabilities	1,345,014		1,343,748
Operating lease liabilities	122,256		113,643
Deferred income tax liability	3,925		1,355
Other long-term liabilities	60,104		57,655
Total liabilities	1,531,299		1,516,401
Commitments and contingencies (see Note 11)
Shareholders’ equity:
Preferred stock - $0.01 par-value; 5,000,000 shares authorized; no shares issued and outstanding at March 31, 2026 and December 31, 2025	—		—
Common stock - $0.01 par-value; 250,000,000 shares authorized at March 31, 2026 and December 31, 2025; 28,559,689 and 28,370,780 shares issued and outstanding at March 31, 2026 and December 31, 2025, respectively	286		284
Treasury stock - 69,623 shares at March 31, 2026 and December 31, 2025	(12,156)		(12,156)
Additional paid-in capital	953,416		935,830
Accumulated deficit	(336,111)		(459,981)
Accumulated other comprehensive loss	(7,121)		(4,906)
Total shareholders’ equity	598,314		459,071
Total liabilities and shareholders’ equity	$	2,129,613	$	1,975,472


(Amounts in thousands, except per share amounts)	Three Months Ended March 31,
	2026		2025
Revenue, net (includes $7.3 million and $13.8 million with related parties for the three months ended March 31, 2026 and 2025, respectively)	$	706,604	$	558,570
Operating expenses:
Direct service costs, excluding depreciation and amortization	198,274		177,816
Reimbursed out-of-pocket expenses	312,004		202,404
Total direct costs	510,278		380,220
Selling, general and administrative	47,917		57,897
Depreciation	6,751		6,694
Amortization	155		236
Total operating expenses	565,101		445,047
Income from operations	141,503		113,523
Other income, net:
Miscellaneous income (expense), net	971		(1,816)
Interest income, net	5,117		6,463
Total other income, net	6,088		4,647
Income before income taxes	147,591		118,170
Income tax provision	23,721		3,575
Net income	$	123,870	$	114,595
Net income per share attributable to common shareholders:
Basic	$	4.35	$	3.77
Diluted	$	4.28	$	3.67
Weighted average common shares outstanding:
Basic	28,445		30,387
Diluted	28,962		31,196


(Amounts in thousands)	Three Months Ended March 31,
	2026		2025
Net income	$	123,870	$	114,595
Other comprehensive (loss) income
Foreign currency translation adjustments, net of taxes	(2,215)		3,122
Comprehensive income	$	121,655	$	117,717


(Amounts in thousands)	Common Stock		Treasury Stock		Additional Paid-In Capital		Retained Earnings (Accumulated Deficit)		Accumulated Other Comprehensive Loss		Total
BALANCE — December 31, 2024	$	306	$	(12,235)	$	844,050	$	8,167	$	(14,743)	$	825,545
Net income							114,595				114,595
Foreign currency translation									3,122		3,122
Stock-based compensation expense					16,892						16,892
Stock options exercised	4				25,941						25,945
Repurchases of common stock	(12)						(392,478)				(392,490)
BALANCE — March 31, 2025	$	298	$	(12,235)	$	886,883	$	(269,716)	$	(11,621)	$	593,609

	Common Stock		Treasury Stock		Additional Paid-In Capital		Retained Earnings (Accumulated Deficit)		Accumulated Other Comprehensive Loss		Total
BALANCE — December 31, 2025	$	284	$	(12,156)	$	935,830	$	(459,981)	$	(4,906)	$	459,071
Net income							123,870				123,870
Foreign currency translation									(2,215)		(2,215)
Stock-based compensation expense					4,918						4,918
Stock options exercised	2				12,668						12,670
BALANCE — March 31, 2026	$	286	$	(12,156)	$	953,416	$	(336,111)	$	(7,121)	$	598,314


	Three Months Ended March 31,
	2026		2025
Operating lease cost	$	7,742	$	8,065
Variable lease cost	$	3,390	$	3,012


	Related Party Operating Leases		Non-Related Parties Operating Leases		Total Operating Leases
Remainder of 2026	$	8,868	$	14,309	$	23,177
2027	10,839		16,671		27,510
2028	8,609		11,779		20,388
2029	8,824		9,441		18,265
2030	9,045		6,840		15,885
Later years	73,800		14,123		87,923
Total lease payments	119,985		73,163		193,148
Less: imputed interest	(37,421)		(9,633)		(47,054)
Total	$	82,564	$	63,530	$	146,094


	Three Months Ended March 31, 2026
	Stock Options	Weighted Average Exercise Price
Outstanding - beginning of period	618,681	$	211.29
Granted	200	$	428.03
Exercised	(92,266)	$	138.80
Outstanding - end of period	526,615	$	224.33

Exercisable - end of period	461,808	$	207.86


			Three Months Ended March 31, 2026
			Shares/Units
Outstanding and unvested - beginning of period			324,517
Granted			3,636
Vested			(96,931)
Forfeited			(2,688)
Outstanding and unvested - end of period			228,534


	Three Months Ended March 31,
(Amounts in thousands, except percentages)	2026		2025		Change		% Change
Revenue, net	$	706,604	$	558,570	$	148,034	26.5	%
Direct service costs, excluding depreciation and amortization	198,274		177,816		20,458		11.5	%
Reimbursed out-of-pocket expenses	312,004		202,404		109,600		54.1	%
Total direct costs	510,278		380,220		130,058		34.2	%
Selling, general and administrative	47,917		57,897		(9,980)		(17.2)	%
Depreciation	6,751		6,694		57		0.9	%
Amortization	155		236		(81)		(34.3)	%
Total operating expenses	565,101		445,047		120,054		27.0	%
Income from operations	141,503		113,523		27,980
Miscellaneous income (expense), net	971		(1,816)		2,787
Interest income, net	5,117		6,463		(1,346)
Income before income taxes	147,591		118,170		29,421
Income tax provision	23,721		3,575		20,146
Net income	$	123,870	$	114,595	$	9,275


(Amounts in thousands)	Three Months Ended March 31,
	2026		2025
CASH FLOWS FROM OPERATING ACTIVITIES:
Net income	$	123,870	$	114,595
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation	6,751		6,694
Amortization	155		236
Stock-based compensation expense	4,918		16,892
Noncash lease expense	5,849		6,064
Deferred income tax provision	18,543		749
Other	400		(502)
Changes in assets and liabilities:
Accounts receivable and unbilled, net	7,822		(2,069)
Prepaid expenses and other current assets	(1,795)		(17,553)
Accounts payable	84		10,720
Accrued expenses	(1,300)		(23,160)
Advanced billings	1,954		8,131
Lease liabilities	(5,294)		(6,548)
Other assets and liabilities, net	(10,169)		11,587
Net cash provided by operating activities	151,788		125,836
CASH FLOWS FROM INVESTING ACTIVITIES:
Property and equipment expenditures	(6,814)		(9,994)
Other	66		7
Net cash used in investing activities	(6,748)		(9,987)
CASH FLOWS FROM FINANCING ACTIVITIES:
Proceeds from stock option exercises	12,670		25,934
Repurchases of common stock	—		(371,900)
Net cash provided by (used in) financing activities	12,670		(345,966)
EFFECT OF EXCHANGE RATES ON CASH, CASH EQUIVALENTS, AND RESTRICTED CASH	(2,078)		2,117
INCREASE (DECREASE) IN CASH, CASH EQUIVALENTS, AND RESTRICTED CASH	155,632		(228,000)
CASH, CASH EQUIVALENTS, AND RESTRICTED CASH — Beginning of period	497,049		669,436
CASH, CASH EQUIVALENTS, AND RESTRICTED CASH — End of period	$	652,681	$	441,436
SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION —
Share repurchases—non-cash	$	—	$	22,343


	As of
	March 31, 2026		December 31, 2025
Intangible assets:
Finite-lived intangible assets:
Carrying amount:
Customer relationships	$	145,051	$	145,051
Accumulated amortization:
Customer relationships	(143,432)		(143,277)
Total finite-lived intangible assets, net	1,619		1,774
Trade name (indefinite-lived)	31,646		31,646
Total intangible assets, net	$	33,265	$	33,420


	Three Months Ended March 31,
	2026		2025
Therapeutic Area
Metabolic	$	237,558	$	148,015
Oncology	201,239		170,476
Other	93,318		95,836
Central Nervous System	80,207		54,901
Cardiology	56,261		58,279
AVAI	38,021		31,063
Total revenue	$	706,604	$	558,570


			MEDPACE HOLDINGS, INC.

			/s/ Kevin M. Brady
			Kevin M. Brady
			Chief Financial Officer (Principal Financial Officer)


	Three Months Ended March 31,
Cash Flows (Amounts in thousands)	2026		2025
Net cash provided by operating activities	$	151,788	$	125,836
Net cash used in investing activities	(6,748)		(9,987)
Net cash provided by (used in) financing activities	12,670		(345,966)
Effect of exchange rates on cash, cash equivalents and restricted cash	(2,078)		2,117
Increase (decrease) in cash, cash equivalents and restricted cash	$	155,632	$	(228,000)

SEC Form 10-Q filed by Medpace Holdings Inc.