Medline Inc. (NASDAQ: MDLN) made waves yesterday with an initial public offering that pulled in $6.26 billion. This move put it at the top of the list for 2025 listings and marked the largest U.S. debut since Rivian Automotive’s back in 2021. Only a handful of companies have managed to raise more than $5 billion in their IPOs over the last ten years, which shows just how rare this scale remains.
Start with two brothers, Jon and Jim Mills, back in 1966. They kicked things off in a garage in Northfield, Illinois, selling basic medical supplies to local hospitals. What began as a small operation grew into a powerhouse over nearly six decades. Today, Medline serves as a major manufacturer and distributor of everything from surgical gloves and gowns to wheelchairs and exam room essentials. Hospitals, surgery centers, physicians’ offices, and post-acute care facilities rely on their catalog of about 335,000 products. Roughly one-third of their branded items come from in-house production across 33 facilities, with the rest sourced from over 500 suppliers in around 40 countries. They also handle distribution for 145,000 third-party products through supply-chain services.
This steady expansion happened through economic ups and downs, including the COVID-19 pandemic, with net sales climbing every year since day one. By 2024, they hit $25.5 billion in net sales, and for the nine months ended late September 2025, revenue reached $20.6 billion alongside $977 million in net income. Prime vendor agreements, where they act as primary suppliers, brought in $16 billion of that 2024 total, with customer retention holding above 98% over the past five years. Competitors like McKesson and Cardinal Health loom large, but Medline carved out dominance in everyday consumables that healthcare cannot skip.
Fast forward to 2021. Private equity firms Blackstone, Carlyle, and Hellman & Friedman swooped in for a $34 billion leveraged buyout, the biggest since the financial crisis. This deal kept Medline private but loaded it with about $16.8 billion in debt by late September 2025. The firms poured resources into growth, yet whispers of an IPO circulated for years. Early plans for 2025 hit snags from tariff uncertainties on Asia-sourced goods, especially from China, where much of their low-cost items originate. CEO Jim Boyle noted they produce about half their output in the U.S. or North America across 19 domestic facilities, giving flexibility to shift manufacturing and blunt tariff hits. Still, they project $150 million to $200 million in pre-tax income pressure from tariffs in fiscal 2026.
The timing finally aligned. Medline priced 216 million Class A shares at $29 each on December 16, upsizing the offering and granting underwriters a 30-day option for 32 million more. Shares debuted on Nasdaq the next day, opening at $35 and closing at $41, a 41% pop that valued the company around $54 billion. Proceeds mainly go to pay down debt from those new shares, while selling shareholders cash out pre-IPO stakes. Boyle emphasized they will run the business as before, just with a louder voice and stronger balance sheet. This debut tops global 2025 IPOs, beating China’s CATL at $5.3 billion, and signals confidence in profitable, cash-rich firms even amid trade worries.
Market watchers see it as a bellwether. Private equity exits like this boost faith in sponsor-backed listings, especially for resilient players. Investors like the profile: steady demand for cheap, essential supplies insulates against recessions. As Carlyle co-head Steve Wise put it, strong growth stories can thrive publicly. Medline’s path reflects a classic arc, from garage hustle to $50 billion valuation, proving endurance pays off when markets open wide.Â
