Total revenue was approximately $105 million, up 3% sequentially, down 7% year-over-year. Additionally, our business in China continues to face headwinds that we discussed during our last earnings call, which pertained to geopolitical tensions and ongoing tariff uncertainty. Given such uncertainty, we believe the responsible approach is to withdraw our financial guidance at this time. This plan was designed to sharpen accountability, tighten cost control, and accelerate execution while positioning Accuray for sustainable, profitable growth over the long term.

We will provide an updated view on these annualized improvements on our fourth quarter earnings call. We will launch packages to add software solutions to our service agreements, which we believe strengthens recurring revenue opportunities and improves customer engagement over time. During the quarter, we have made enhancements to our service systems, which are designed to improve cash conversion and margin quality. This work is designed to support competitive wins at appropriate margins and is expected to translate into stronger sales quality and margin expansion over time.

Paul brings more than two decades of experience leading and scaling global capital medical device businesses across the Americas, EMEA, and APAC regions. In prior roles, his leadership helped drive the reversal of revenue decline trends and helped deliver double-digit annual growth. Each bring distinct capabilities across imaging, software, workflow innovation, clinical research, treatment continuity, and operational execution. Together, these partnerships allow us to deliver more comprehensive solutions to radiation medicine teams while improving speed to market and capital efficiency.

What went well
  • Revenue of ~$105 million grew 3% sequentially, and the service business remained resilient at $55.1 million with a service contract capture rate of nearly 90% of active systems.
  • The transformation ran ahead of plan: ~$10 million of the originally targeted $12 million of fiscal 2026 improvements were already achieved, and management expects to exceed the $12 million target and realize at least $25 million annualized in fiscal 2027.
  • Adjusted operating expenses (excluding restructuring and a prior-year item) fell about $6 million or 18% year-over-year, showing cost actions taking hold.
  • Paul Miele joined as Chief Commercial Officer, bringing more than two decades of global capital medical-device leadership, alongside a new VP of distributor partnerships.
  • Accuray advanced a partnership-driven strategy -- a Radiosurgery Society-sponsored multi-center motion-tracking registry plus collaborations with the University of Wisconsin-Madison and Tata Consultancy Services -- and secured $0.6 million of service price favorability from renewal pricing.
What went wrong
  • Net revenue fell 7% year-over-year (down 10% constant currency) to $104.8 million, with product revenue down 13% to $49.7 million.
  • Product shipments to certain Middle East, North Africa and Pakistan customers were delayed indefinitely due to geopolitical disruption, also hitting service revenue by about $1.2 million.
  • China continued to face geopolitical and tariff headwinds, adding volatility largely outside the company's control.
  • Overall gross margin fell to 24.1% from 27.9%, driven by service margins of 26.1% (vs. 33.3%) on higher net parts consumption (~600 bps) plus logistics/duties, and tariffs hit service (~$0.8 million/150 bps) and product (~$2.6 million/530 bps).
  • Operating loss was $9.1 million (vs. $1.1 million income) and adjusted EBITDA fell to $3.8 million from $6.0 million, including $6.5 million of non-recurring restructuring expense; cash was $44.4 million.

Guidance Changes

MetricPeriodCurrent guidance
Fiscal 2026 financial guidanceFY2026Withdrawn -- management withdrew guidance given Middle East and China unpredictability; an update to come with fiscal Q4 results
Transformation savingsFY2026 / FY2027~$10 million already achieved by end of Q3; on track to exceed $12 million in FY2026 and at least $25 million annualized in FY2027
Restructuring chargesFY2026Expected to decrease sequentially from the $6.5 million Q3 level, with a significant portion recognized by fiscal year-end
Multi-year financial inflectionFY2027-FY20282027 and 2028 financial performance expected to reflect the benefits of current transformation actions

Performance Breakdown

MetricYoYNote
Net revenue -7% to $104.8 million (-10% cc, +3% sequential) Indefinite Middle East/North Africa/Pakistan shipment delays and continued China headwinds.
Product revenue -13% to $49.7 million Majority of the year-over-year decline; China macro headwinds and Middle East geopolitical disruption.
Service revenue -1% to $55.1 million (-5% cc) ~$1.2 million Middle East impact, partly offset by $0.6 million of renewal price favorability; capture rate ~90%.
Overall gross margin 24.1% vs. 27.9% Service margin fell to 26.1% on higher net parts consumption (~600 bps) and logistics/duties; tariffs hurt both service and product.
Adjusted EBITDA $3.8 million vs. $6.0 million Revenue decline and gross-margin pressure, partly offset by ~18% lower adjusted operating expenses.
Backlog / book-to-bill ~$356 million backlog; 1.0x book-to-bill (1.2x TTM) ~$49 million of product gross orders in the quarter amid the disrupted demand environment.

Earnings Call Themes & Trends

TopicPrevious mentionCurrent periodTrend
Guidance withdrawal$440-$450M revenue / $22-$25M adjusted EBITDAWithdrawn due to indefinite Middle East shipment delays (EMEA is Accuray's largest region) and China unpredictability; update promised with Q4 results.
Transformation execution~$12M FY2026 targetAhead of plan with ~$10M achieved; expects to exceed $12M in FY2026 and at least $25M annualized in FY2027; restructuring costs to taper.
Service monetizationSolutions-oriented tiersLaunched new training/education solutions (bundled or standalone), added software packages to service agreements, and improved systems/controls for billing and cash conversion; ~90% contract capture.
Commercial leadership and distributorsCCO appointment signaledPaul Miele joined as CCO; a new VP of distributor partnerships was appointed to elevate distributor performance and accountability globally.
Partnership-driven modelUW-Madison MOUBuilding an ecosystem including a Radiosurgery Society motion-tracking registry, University of Wisconsin-Madison and Tata Consultancy Services, to turn real-time motion-tracking data into a clinical evidence engine and speed time-to-market.
Pricing optimizationValue-based pricing initiativeRenewal pricing delivered $0.6 million of service price favorability in the quarter, with multi-year benefit expected to build over the next two to three years.

Q&A Summary

Marie Thibault (BTIG) asked why Accuray withdrew guidance entirely rather than just revising out the affected Middle East customers.
La Neve said shipments to Middle East, North Africa and Pakistan customers were delayed indefinitely, hitting both product and associated service revenue; because EMEA is Accuray's largest region (with the Middle East and North Africa its fastest-growing sub-regions) and given interdependencies worldwide, withdrawing guidance was the most prudent course amid such dynamic disruption.
Marie Thibault (BTIG) asked why adjusted EBITDA came in well below expectations despite being ahead on cost-cutting, and whether profitability can improve amid the macro uncertainty.
Pervaiz said the transformation is moving well and ahead of plan on workforce reductions, reorganization and cost/spend rationalization, but the main pillars -- service focus, the distributor partnership model and pricing optimization -- take time to flow through, with timing hard to anticipate; he still expects a solid annualized benefit in fiscal 2027.

More on Accuray Inc

Reported 2026-05-06 · figures from the Accuray Inc Q3 2026 earnings call.

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