At a glance
XHE charges 0.35% a year, below the 0.5% average of the 3 funds most like it (the cheapest of 4). It has $151.4M in assets, the 3rd largest of that group; it paid 0.02% of its price in distributions over the past 12 months, annual. Over the past year it returned +14.1% with distributions reinvested (S&P 500: +11.5%), 2nd of those 4 funds; over three years it returned +11.7% a year. At its worst it fell 33.7% in the 2022 bear market (S&P 500: 24.5%), and is still below its earlier high. Its ten largest positions make up 19.2% of the fund, out of 67 in all.
The short version
SPDR S&P Health Care Equipment ETF (XHE) is a State Street index fund. It tracks the S&P Health Care Equipment Select Industry Index, which held 66 U.S. medical device and supply companies as of July 31, 2026. Each stock gets roughly equal weight, so smaller firms like Butterfly Network count about as much as larger names like Edwards Lifesciences. At 0.35% a year, it was the cheapest of the four similar funds compared.
Price history
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XHE +14.1% over the year to Oct 27, 2026, total return with distributions reinvested.
How it has behaved
| YTD | 1 yr | 3 yr | 5 yr | 10 yr | Since start | |
|---|---|---|---|---|---|---|
| XHE official prospectus, to Dec 31, 2025 | — | -0.55% | — | -4.95% | +7.26% | — |
| XHE price data to Oct 27, 2026 | +5.7% | +14.1% | +11.7% | -5.6% | — | +1.0% |
- Over the year to Oct 27, 2026, XHE returned +14.1%, 2nd of 4 among similar funds.
- Its 5-year annualized return was -5.6%.
- Its worst full calendar year was 2022 (-23.3%); its best was 2024 (+5.1%).
- The deepest fall in its price history was 49.9% (Sep 2, 2021 to Oct 30, 2023), not yet recovered.
Show as a table
| Year | Price data | Prospectus (official) |
|---|---|---|
| 2026 (to date) | +5.7% | — |
| 2025 | -0.2% | -0.55% |
| 2024 | +5.1% | +5.09% |
| 2023 | -6.2% | -5.97% |
| 2022 | -23.3% | -23.48% |
| 2021 | +3.0% | +3.18% |
| 2020 | — | +32.69% |
| 2019 | — | +22.39% |
| 2018 | — | +9.28% |
| 2017 | — | +30.00% |
| 2016 | — | +12.65% |
| 2008 financial crisis stocks fell Oct 9, 2007 – Mar 9, 2009 | Before this security existed |
|---|---|
| 2020 COVID crash stocks fell Feb 19, 2020 – Mar 23, 2020 | Not in the price data, which starts Jun 2, 2020 |
| 2022 bear market stocks fell Jan 3, 2022 – Oct 12, 2022 | Lost 31.3% over that stretch · deepest drop along the way 33.7%, not recovered by the end of the data |
Dividends and income
Show as a table
| Year | Per share | Change |
|---|---|---|
| 2025 | $0.0700 | +75.0% |
| 2024 | $0.0400 | +33.3% |
| 2023 | $0.0300 | -9.1% |
| 2022 | $0.0330 | +1550.0% |
| 2021 | $0.0020 |
What's inside
As of Jun 30, 2026, the fund held 67 securities; the ten largest made up 19.23% of assets. It also reported 6.96% in a money-market fund, most likely cash collateral from lending out shares rather than uninvested money.
| Holding | Weight | |
|---|---|---|
| Butterfly Network Inc | 2.56% | |
| QuidelOrtho Corp | 2.13% | |
| Glaukos Corp | 1.87% | |
| UFP Technologies Inc | 1.87% | |
| Axogen Inc | 1.83% | |
| Lantheus Holdings Inc | 1.82% | |
| Artivion Inc | 1.80% | |
| Envista Holdings Corp | 1.80% | |
| Omnicell Inc | 1.78% | |
| Medline Inc | 1.76% | |
| Alphatec Holdings Inc | 1.75% | |
| DENTSPLY SIRONA Inc | 1.73% | |
| Inspire Medical Systems Inc | 1.73% | |
| Cooper Cos Inc | 1.73% | |
| Edwards Lifesciences Corp | 1.73% |
By country
United States 92.27%Ireland 3.25%United Kingdom 1.72%Jersey 1.49%Bermuda 1.17%By asset type
Stocks 99.89%What changed recently
- Over the three months to Jun 30, 2026, investors added a net $5.9M (creations minus redemptions, per the N-PORT report).
- Monthly total returns reported for that quarter: +3.45%, -1.86%, +5.77%.
How it works
XHE tries to match the S&P Health Care Equipment Select Industry Index, which is built by S&P Dow Jones Indices. The index starts from the S&P Total Market Index, a measure of the broad U.S. stock market. It keeps only U.S.-based companies classed as health care equipment or health care supplies makers. To join, a company generally needs a float-adjusted market value (the value of shares actually available to trade) of at least $500 million, and its shares must trade often relative to its size. A member is removed if its value falls below $300 million or its trading dries up. As of July 31, 2026, the index held 66 stocks.
The index is modified equal weighted. Instead of giving the biggest companies the most weight, it spreads money roughly evenly across its members. As of June 30, 2026, the largest position, Butterfly Network, was about 2.6% of the fund, and the top 10 made up about 19%. The index rebalances quarterly, on the third Friday of March, June, September and December, with a second reweighting near the end of those months.
The adviser, SSGA Funds Management, may hold only a sample of the index stocks, but it must keep at least 80% of net assets in index securities. It may also use futures contracts to manage cash. Portfolio turnover was 42%.
What it really costs
- XHE charges 0.35% a year, versus an average of 0.5% for the similar funds below (1st of 4, cheapest first).
- Using the prospectus's standard example, $10,000 invested would cost about $36 in the first year and $443 over 10 years (assuming a 5% annual return).
| Cost of $10,000 (SEC example) | 1 yr | 3 yrs | 5 yrs | 10 yrs |
|---|---|---|---|---|
| XHE | $36 | $113 | $197 | $443 |
In a retirement portfolio
It is a narrow, volatile bet on one industry with almost no income, so it fits best as a small add-on next to broader holdings.
XHE adds focused exposure to U.S. medical device and supply makers, but the ride has been rough. Its price history starts in June 2020, so it doesn't show how the fund held up in 2008 or the 2020 crash. In the 2022 bear market it fell 33.7% between January 3 and June 16, 2022. Its worst calendar year in the prospectus was 2022, at -23.48%. Its deepest drop was 49.9%, from September 2021 to October 2023, and it had not recovered as of October 27, 2026. Anyone forced to sell during a stretch like that would lock in losses. The yield was 0.02% as of October 27, 2026, paid once a year, so it offers almost no income. Costs are low at 0.35%, or $36 in the first year on $10,000 under the SEC's standard example. Past results don't predict the future, and a plan should look at the whole portfolio, not one fund.
Who it may suit — and who should look elsewhere
May suit
- Investors who want a low-cost slice of U.S. medical device makers, at 0.35% compared with a 0.50% average for the three similar funds.
- Those who prefer equal weighting: no single stock was more than about 2.6% of the fund as of June 30, 2026.
- Long-term holders who can sit through deep drops, such as the 49.9% decline that had not recovered as of October 27, 2026.
Look elsewhere if
- Income seekers: the yield was just 0.02% as of October 27, 2026, paid once a year.
- Investors who want broad health care exposure; this fund holds only equipment and supply companies, not drugmakers, insurers or hospitals.
- Anyone who needs steadier results: the five-year average annual return was -4.95% through December 31, 2025.
Close alternatives
Matched by holdings overlap from the latest N-PORT reports.
Net assets from each fund's latest N-PORT or annual report where available. Returns through Oct 27, 2026.Questions investors ask
Does XHE pay a dividend?
Yes, but it is tiny. XHE pays once a year, and its trailing 12-month yield was 0.02% as of October 27, 2026, or about $0.02 per share. The fund owns medical device and supply companies, and its return comes almost entirely from changes in share prices, not income. Investors who need regular cash flow would have to sell shares to get it, which can hurt in a falling market.
What's the difference between XHE and IHI?
Both funds focus on U.S. medical device companies, and their holdings overlapped by 36%. XHE costs 0.35% a year versus 0.40% for the iShares U.S. Medical Devices ETF (IHI). IHI is far larger, with about $3.02 billion in net assets versus XHE's $151.4 million as of June 30, 2026. XHE gives its stocks roughly equal weight. As of October 27, 2026, XHE returned 14.1% over one year versus -12.2% for IHI, and 11.7% versus 7.5% a year over three years.
What are XHE's top holdings?
As of June 30, 2026, XHE's largest positions were Butterfly Network (2.56%), QuidelOrtho (2.13%), Glaukos (1.87%), UFP Technologies (1.87%) and Axogen (1.83%). Because the index is roughly equal weighted, no single stock dominates. The fund held 67 stocks, and the top 10 made up only 19.23% of assets. About 92% was in U.S.-listed companies, with small amounts in companies based in Ireland, the United Kingdom, Jersey and Bermuda.
How much does XHE cost per year?
XHE's expense ratio is 0.35%, according to the prospectus filed October 26, 2026. That is the lowest of the four similar funds compared, where the average was 0.50%. Under the SEC's standard example, $10,000 invested with a 5% yearly return would cost about $36 in fees after one year, $197 after five years and $443 after ten years. The fee comes out of the fund's assets, not as a separate bill.
Is XHE good for retirement?
XHE is a narrow, volatile fund, so it fits better as a small satellite holding than as a core holding. Its biggest drop was 49.9%, from September 2021 to October 2023, and it had not recovered as of October 27, 2026. Its one-year volatility was 22.4%, and it pays almost no income. Its ten-year average annual return was 7.26% through December 31, 2025. Past results don't predict the future.