Tempus AI: Can $1.36B Revenue and 36% Growth Overcome Profitability Concerns?

Executive Summary May 20, 2026

Tempus AI, Inc. (TEM)

Live Market Price

45.53 USD

Key Takeaway 01

Revenue Growth: Tempus AI reported trailing twelve-month (TTM) revenue of $1.36B, representing a robust 36.10% year-over-year growth, signaling strong adoption of its AI-driven precision medicine platform.

Key Takeaway 02

Valuation Challenge: Despite the growth, the company remains unprofitable with a Trailing EPS of -1.72, a negative Forward P/E of -335.20, and a Debt-to-Equity ratio of 316.65%, raising questions about near-term financial sustainability.

Key Takeaway 03

Share Price Pressure: Trading at $45.53, the stock sits 56.3% below its 52-week high of $104.32, reflecting market skepticism about its path to profitability despite a $8.18B market capitalization.

Disclaimer: This article is for informational and educational purposes only. It does not constitute financial advice, investment recommendations, or an offer to sell or a solicitation of an offer to buy any securities.

NARRATIVE & THEME

Tempus AI, Inc. operates at the intersection of healthcare and artificial intelligence, building a vast library of clinical and molecular data to power precision medicine. The core thesis is that by processing massive amounts of genomic sequencing, pathology images, and electronic health records, Tempus can generate actionable insights for oncologists, cardiologists, and other specialists. The company's platform is designed to improve diagnostic accuracy, personalize treatment plans, and accelerate drug discovery.

The macro theme driving Tempus is the accelerating digitization of healthcare and the growing acceptance of AI-assisted clinical decision-making. With global healthcare systems under pressure to improve outcomes while controlling costs, Tempus positions itself as an infrastructure layer for data-driven medicine. The $1.36B in TTM revenue demonstrates that this thesis is gaining traction, particularly as the company projects $1.59B in 2026 sales (per Stock Titan), implying continued momentum. However, the stark contrast between its revenue growth and persistent losses defines the central tension for the company.

FINANCIAL METRICS & VALUATION

• Revenue (TTM): $1.36B
• Revenue Growth (YoY): 36.10%
• Trailing EPS: -1.72
• Gross Margin: 63.39% — a healthy margin indicating strong unit economics on the data services side.
• Operating Margin: -24.33% — high operating expenses relative to revenue, typical for a growth-stage AI company.
• Profit Margin: -22.20% — the company is not yet profitable on a GAAP basis.
• P/E Ratio (Trailing): N/A — negative earnings preclude a meaningful trailing P/E.
• P/E Ratio (Forward): -335.20 — the forward multiple reflects market expectations of continued losses.
• P/S Ratio: N/A — not calculated due to negative earnings.
• EV/EBITDA: -47.80 — negative enterprise value relative to EBITDA indicates the company is burning cash.
• Debt-to-Equity: 316.65% — high leverage, suggesting significant debt financing relative to equity.
• Free Cash Flow (TTM): -$55.76M — negative free cash flow, though the burn rate is manageable given cash reserves.
• Cash & Equivalents: $639.07M — provides a runway to fund operations without immediate capital raise concerns.

COMPETITOR COMPARISON

Tempus AI, Inc. (TEM)

• Market Cap: $8.18B
• Revenue (TTM): $1.36B
• Revenue Growth (YoY): 36.10%
• Gross Margin: 63.39%
• Operating Margin: -24.33%
• P/E Ratio (Trailing): N/A
• P/S Ratio: N/A

Nebius Group N.V. (NBIS)

• Market Cap: $50.20B
• Revenue (TTM): $877.9M
• Revenue Growth (YoY): 621.50% — explosive growth driven by AI infrastructure demand.
• Gross Margin: 72.06%
• Operating Margin: -32.08%
• P/E Ratio (Trailing): N/A
• P/S Ratio: N/A

CoreWeave, Inc. (CRWV)

• Market Cap: $54.45B
• Revenue (TTM): $6.23B
• Revenue Growth (YoY): 111.60%
• Gross Margin: 69.38%
• Operating Margin: -6.93% — closer to operating breakeven than Tempus.
• P/E Ratio (Trailing): N/A
• P/S Ratio: N/A

Oklo Inc. (OKLO)

• Market Cap: $9.72B
• Revenue (TTM): N/A
• Revenue Growth (YoY): N/A — pre-revenue company.
• Gross Margin: 0.00%
• Operating Margin: 0.00%
• P/E Ratio (Trailing): N/A
• P/S Ratio: N/A

MILESTONE CHECKPOINTS

• [Late August 2026] — Q2 2026 Earnings Report: Investors will scrutinize revenue trajectory against the $1.59B full-year 2026 guidance and any updates on operating expense management.
• [Q3 2026] — Cardiology AI Commercial Launch: Following the projected growth in AI cardiology, Tempus may announce new product rollouts or partnership expansions targeting this vertical.
• [Q4 2026] — Potential FDA Clearance Submissions: Tempus has ongoing regulatory engagements for AI-based diagnostic tools; announcements could serve as significant catalysts.
• [Early 2027] — Full-Year 2026 Earnings: A critical eye will be on whether the company can narrow its operating margin from -24.33% toward breakeven while maintaining 30%+ revenue growth.
• [Ongoing] — Debt Refinancing or Equity Raise: Given a Debt-to-Equity ratio of 316.65%, any news about capital structure optimization will be closely watched.

CATALYST & MARKET TAILWINDS

• Revenue Growth Momentum: A 36.10% YoY growth rate on a $1.36B base demonstrates product-market fit and expanding customer adoption across health systems and pharmaceutical partners.
• Cardiology Expansion: As highlighted in the Stock Titan report, Tempus projects $1.59B in 2026 sales with AI in cardiology as a key growth driver, tapping into a large addressable market beyond oncology.
• Data Network Effects: Tempus's unique position as a data aggregator creates compounding value—more data improves algorithm accuracy, which attracts more customers, which generates more data. This virtuous cycle is a structural competitive advantage.
• Cash Position: With $639.07M in cash and equivalents, Tempus has significant runway to invest in growth without near-term liquidity pressure, even with negative free cash flow of -$55.76M.
• Regulatory Tailwinds: Increasing FDA interest in AI-enabled medical devices provides a clear regulatory pathway for Tempus's products, potentially accelerating commercial adoption.

BLINDSPOTS & MARKET HEADWINDS

• Profitability Uncertainty: A negative operating margin of -24.33% and negative free cash flow indicate the company is still heavily dependent on external capital to fund operations. The path to positive net income remains unclear.
• High Debt Burden: With a Debt-to-Equity ratio of 316.65%, Tempus carries significant financial leverage. Rising interest rates or a tightening credit market could increase financing costs and strain the balance sheet.
• Valuation Disconnect: The stock trades at $45.53, down from a 52-week high of $104.32, suggesting the market is pricing in execution risk and questioning the sustainability of growth. The negative forward P/E of -335.20 reflects deep uncertainty.
• Competitive Pressure: While Tempus focuses on healthcare AI, competitors like CoreWeave ($6.23B revenue) and Nebius Group (621.50% growth) are much larger and growing faster, potentially attracting more customer attention and talent.
• Revenue Concentration Risk: Tempus's revenue is heavily tied to oncology and now cardiology. Any regulatory setback in these verticals or a slowdown in diagnostic testing volumes could materially impact the top line.
• Macro Headwinds: Healthcare spending, while recession-resistant, is not immune to budget cuts. Hospitals and payers may delay large AI platform deployments during economic uncertainty.

CONCLUDING THOUGHTS

Tempus AI presents a compelling narrative: a data-driven healthcare AI company generating $1.36B in revenue with 36.10% annual growth and a healthy 63.39% gross margin. The company has carved out a defensible position at the intersection of genomics, imaging, and clinical data, with expansion into cardiology offering further upside. However, the financial reality is equally stark: persistent losses, a 316.65% debt-to-equity ratio, negative free cash flow, and a stock price that has shed more than half its value from the 52-week high. The market is asking Tempus to prove it can translate top-line growth into sustainable profitability while managing its leverage. The upcoming milestones—particularly the Q2 2026 earnings and the full-year 2026 guidance—will be critical in determining whether this growth story can regain investor confidence or whether the headwinds will continue to weigh on the stock.