At a glance
XLV charges 0.08% a year, below the 0.42% average of the 8 funds most like it (the cheapest of 9). It has $40.60B in assets, the largest of that group; it paid 1.38% of its price in distributions over the past 12 months, quarterly. Over the past year it returned +30.2% with distributions reinvested (S&P 500: +11.5%), 2nd of those 9 funds; over three years it returned +16.2% a year. At its worst it fell 16.1% in the 2022 bear market (S&P 500: 24.5%), and was back at its earlier high 19 months after the low. Its ten largest positions make up 61.5% of the fund, out of 59 in all.
The short version
Health Care Select Sector SPDR Fund (XLV) is a State Street index fund that holds the roughly 60 health care companies in the S&P 500. It charges 0.08% a year, the lowest among similar health care funds, which average 0.42%, though Vanguard's VHT and Fidelity's FHLC cost nearly the same. It is top-heavy: as of June 30, 2026, Eli Lilly alone made up 16.5% of assets, and the top 10 holdings 61.6%.
Price history
The interactive chart needs JavaScript.
XLV +30.2% over the year to Oct 30, 2026, total return with distributions reinvested.
How it has behaved
| YTD | 1 yr | 3 yr | 5 yr | 10 yr | Since start | |
|---|---|---|---|---|---|---|
| XLV official prospectus, to Dec 31, 2025 | — | +14.51% | — | +8.10% | +9.75% | — |
| XLV price data to Oct 30, 2026 | +20.9% | +30.2% | +16.2% | +8.4% | — | +11.4% |
- Over the year to Oct 30, 2026, XLV returned +30.2%, 2nd of 9 among similar funds.
- Its 5-year annualized return was +8.4%.
- Its worst full calendar year was 2022 (-2.1%); its best was 2021 (+26.0%).
- The deepest fall in its price history was 17.1% (Sep 16, 2024 to May 14, 2025), recovered by Nov 21, 2025.
Show as a table
| Year | Price data | Prospectus (official) |
|---|---|---|
| 2026 (to date) | +20.9% | — |
| 2025 | +14.5% | +14.51% |
| 2024 | +2.5% | +2.50% |
| 2023 | +2.1% | +1.99% |
| 2022 | -2.1% | -2.05% |
| 2021 | +26.0% | +25.92% |
| 2020 | — | +13.27% |
| 2019 | — | +20.66% |
| 2018 | — | +6.29% |
| 2017 | — | +21.70% |
| 2016 | — | -2.83% |
| 2008 financial crisis stocks fell Oct 9, 2007 – Mar 9, 2009 | Not in the price data, which starts Jun 2, 2020 |
|---|---|
| 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 11.6% over that stretch · deepest drop along the way 16.1%, back to its old high 18.5 months after the low |
Dividends and income
Show as a table
| Year | Per share | Change |
|---|---|---|
| 2026 (to date) | $1.8900 | |
| 2025 | $2.4700 | +7.9% |
| 2024 | $2.2900 | +5.5% |
| 2023 | $2.1700 | +8.5% |
| 2022 | $2.0000 | +6.4% |
| 2021 | $1.8800 |
What's inside
As of Jun 30, 2026, the fund held 59 securities; the ten largest made up 61.55% of assets.
| Holding | Weight | |
|---|---|---|
| Eli Lilly & Co | 16.51% | |
| Johnson & Johnson | 10.64% | |
| AbbVie Inc | 7.74% | |
| UnitedHealth Group Inc | 6.57% | |
| Merck & Co Inc | 5.52% | |
| Amgen Inc | 3.40% | |
| Thermo Fisher Scientific Inc | 3.24% | |
| Abbott Laboratories | 2.75% | |
| Gilead Sciences Inc | 2.73% | |
| Intuitive Surgical Inc | 2.45% | |
| Pfizer Inc | 2.39% | |
| CVS Health Corp | 2.30% | |
| Vertex Pharmaceuticals Inc | 2.19% | |
| Danaher Corp | 2.09% | |
| Bristol-Myers Squibb Co | 2.05% |
By country
United States 97.57%Ireland 2.11%By asset type
Stocks 99.68%By sector
Sectors of the companies held, for the 89% of the fund in companies that have a stock page here; other holdings and cash aren't classified. Source: N-PORT holdings report as of Jun 30, 2026. Cash, money-market funds and derivatives are shown separately from the securities list.What changed recently
- Over the three months to Jun 30, 2026, investors withdrew a net $1.06B (creations minus redemptions, per the N-PORT report).
- Monthly total returns reported for that quarter: -0.46%, +2.47%, +6.60%.
How it works
XLV tracks the Health Care Select Sector Index, one of 11 Select Sector indexes calculated by S&P Dow Jones Indices. Only S&P 500 companies labeled health care under the Global Industry Classification Standard (GICS), a widely used system for sorting companies by industry, can be included. That covers pharmaceuticals, biotechnology, health care equipment and supplies, providers and services, life sciences tools and health care technology. The index held 60 stocks as of November 30, 2025.
Stocks are weighted by market value (share price times shares outstanding), so the biggest companies count most. S&P may trim very large single positions so the fund meets diversification rules in the federal tax code. Even so, as of June 30, 2026, Eli Lilly was 16.5% of the fund, Johnson & Johnson 10.6% and AbbVie 7.7%. The fund is classified as non-diversified, so a slump in one big holding can hurt more than it would in a broader fund.
The adviser, SSGA Funds Management, uses replication. That means it holds substantially all the index stocks in about the same proportions and keeps at least 95% of assets in them, rather than picking winners. The rest can sit in cash or money market funds. The prospectus reports 2% portfolio turnover, which means very little trading. Like any ETF, its market price can drift slightly above or below the value of its holdings.
What it really costs
- XLV charges 0.08% a year, versus an average of 0.42% for the similar funds below (1st of 9, cheapest first).
- Of that, 0.03% is the management fee; the rest covers other fund expenses.
- Using the prospectus's standard example, $10,000 invested would cost about $8 in the first year and $103 over 10 years (assuming a 5% annual return).
| Cost of $10,000 (SEC example) | 1 yr | 3 yrs | 5 yrs | 10 yrs |
|---|---|---|---|---|
| XLV | $8 | $26 | $45 | $103 |
In a retirement portfolio
Its calendar-year losses from 2016 through 2025 never topped 2.83%, but it is still an all-stock, single-sector fund that has dropped as much as 17.1% since mid-2020.
XLV could add extra weight in US health care companies at low cost. Its calendar-year losses have been small: its worst year from 2016 to 2025 was 2016, down 2.83%, and 2022 was down 2.05%. Drops within years ran deeper. It fell 12.69% in the first quarter of 2020, and it fell 16.1% between April and June 2022, then needed 18.5 months to recover. Its deepest drop since mid-2020, 17.1%, ended in May 2025, and it regained its high about six months later. Withdrawals made near such lows lock in losses.
Income is modest: the yield was 1.42% as of October 27, 2026, paid quarterly. Costs are low: $8 in year one on $10,000 in the SEC's standard example. S&P 500 funds already own these stocks, so XLV adds sector weight, not new companies. 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 wanting more US health care exposure at low cost: 0.08% a year, or $8 the first year on $10,000 in the SEC's example.
- Long-term holders who value size and history: launched in 1998, it held $40.6 billion as of June 30, 2026, the most among similar funds.
- Investors who value a record of mild yearly losses: from 2016 through 2025, its worst calendar year was a 2.83% decline, in 2016.
Look elsewhere if
- Retirees who need meaningful income: XLV yielded 1.42% as of October 27, 2026, paid quarterly, so returns depend mostly on share prices.
- Owners of S&P 500 funds seeking new companies: every stock in XLV's index is already an S&P 500 member, adding only health care weight.
- Investors wary of concentration: Eli Lilly was 16.5% of assets on June 30, 2026; equal-weight RSPH spreads money more evenly but costs 0.40%.
Close alternatives
Matched by holdings overlap from the latest N-PORT reports.
| Fund | Overlap | Cost | Net assets | 1 yr | 3 yr |
|---|---|---|---|---|---|
| XLV this fund | — | 0.08% | $40.60B | +30.2% | +16.2% |
| IYH iShares U.S. Healthcare ETF | 89% | 0.39% | $3.56B | +23.8% | +15.0% |
| FHLC Fidelity MSCI Health Care Index ETF | 85% | 0.084% | $3.29B | +23.8% | +16.0% |
| VHT Vanguard Health Care ETF | 85% | 0.09% | $22.04B | +28.9% | +16.9% |
| IXJ iShares Global Healthcare ETF | 71% | 0.41% | $3.84B | +19.5% | +13.4% |
| JDOC JPMorgan Healthcare Leaders ETF | 56% | 0.65% | $9.1M | +15.7% | — |
| RSPH Invesco S&P 500 Equal Weight Health Care ETF | 52% | 0.4% | $766.9M | +28.4% | +16.6% |
| GDOC Future Health Care Equity ETF | 45% | 0.75% | $19.6M | +9.7% | +11.2% |
Compared head to head: VHT vs XLV · all comparisons →
Questions investors ask
What are XLV's top holdings?
As of June 30, 2026, XLV's largest holdings were Eli Lilly (16.5%), Johnson & Johnson (10.6%), AbbVie (7.7%), UnitedHealth Group (6.6%) and Merck (5.5%). Amgen, Thermo Fisher Scientific, Abbott Laboratories, Gilead Sciences and Intuitive Surgical completed the top 10, which together made up 61.6% of the fund. It held 59 companies in all, each an S&P 500 member classified as health care, so a handful of large firms drive much of its return.
What's the difference between XLV and VHT?
Not much. The holdings of XLV and Vanguard Health Care ETF (VHT) overlap by about 85%, based on their latest holdings reports, and they cost almost the same: 0.08% a year for XLV versus 0.09% for VHT. Through October 27, 2026, XLV returned 24.4% over one year to VHT's 23.7%, while VHT led over three years, 16.1% a year to 15.2%. XLV owns only S&P 500 health care stocks. iShares' IYH overlaps even more, at 89%, but charges 0.39%.
What is XLV's 10-year average return?
XLV returned an average of 9.75% a year over the 10 years ended December 31, 2025, and 8.10% a year over five years, according to its prospectus. Yearly results were uneven, ranging from a 25.92% gain in 2021 to a 2.83% loss in 2016, with modest gains of 1.99% in 2023 and 2.50% in 2024. Through October 27, 2026, it was up 17.2% for the year to date. Past returns don't predict future results.
Does XLV pay dividends monthly or quarterly?
Quarterly. Over the 12 months to October 27, 2026, XLV paid $2.55 per share, a yield of 1.42% based on those payments. The money comes from dividends paid by the companies it holds, after fund expenses, so the amount can rise or fall. That yield is modest, so XLV works mainly as a way to own health care stocks rather than as a source of retirement income.
Is XLV a safe investment?
No. Like any stock fund, XLV can lose money, though its yearly losses have been mild. Its worst calendar year from 2016 through 2025 was a 2.83% loss in 2016, and it lost 2.05% in 2022. Drops within a year ran deeper: it fell 12.69% in the first quarter of 2020 and 17.1% from September 2024 to May 2025. The prospectus also warns that limits on government reimbursement can hurt health care profits, and the fund holds just one sector.