Medpace Holdings, Inc. 10-Q

Item 1. Financial Statements MEDPACE HOLDINGS, INC. AND SUBSIDIARIES CONDENSED CONSOLIDATED BALANCE SHEETS (UNAUDITED) (Amounts in thousands, except share amounts) As of September 30, 2026 December 31, 2025 ASSETS Current assets: Cash and cash equivalents $ 705,315 $ 497,049 Accounts receivable and unbilled, net (includes $ 2.9 million and $ 3.5 million with related parties at September 30, 2026 and December 31, 2025, respectively) 447,642 402,078 Prepaid expenses and other current assets 92,043 90,497 Total current assets 1,245,000 989,624 Property and equipment, net 175,004 131,055 Operating lease right-of-use assets 152,549 117,815 Goodwill 662,396 662,396 Intangible assets, net 32,955 33,420 Deferred income taxes 3,272 19,223 Other assets 31,419 21,939 Total assets $ 2,302,595 $ 1,975,472 LIABILITIES AND SHAREHOLDERS’ EQUITY Current liabilities: Accounts payable (includes $ 0.3 million with related parties at September 30, 2026 and December 31, 2025) $ 43,682 $ 28,142 Accrued expenses 443,331 408,382 Advanced billings (includes $ 12.2 million and $ 12.3 million with related parties at September 30, 2026 and December 31, 2025, respectively) 961,855 854,390 Other current liabilities 47,229 52,834 Total current liabilities 1,496,097 1,343,748 Operating lease liabilities 146,041 113,643 Deferred income tax liability 13,657 1,355 Other long-term liabilities 61,861 57,655 Total liabilities 1,717,656 1,516,401 Commitments and contingencies (see Note 11) Shareholders’ equity: Preferred stock - $ 0.01 par-value; 5,000,000 shares authorized; no shares issued and outstanding at September 30, 2026 and December 31, 2025 — — Common stock - $ 0.01 par-value; 250,000,000 shares authorized at September 30, 2026 and December 31, 2025; 27,966,686 and 28,370,780 shares issued and outstanding at September 30, 2026 and December 31, 2025, respectively 280 284 Treasury stock - 69,593 and 69,623 shares at September 30, 2026 and December 31, 2025, respectively ( 12,151 ) ( 12,156 ) Additional paid-in capital 978,282 935,830 Accumulated deficit ( 373,573 ) ( 459,981 ) Accumulated other comprehensive loss ( 7,899 ) ( 4,906 ) Total shareholders’ equity 584,939 459,071 Total liabilities and shareholders’ equity $ 2,302,595 $ 1,975,472 See notes to condensed consolidated financial statements. -3- Table of Contents MEDPACE HOLDINGS, INC. AND SUBSIDIARIES CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS (UNAUDITED) (Amounts in thousands, except per share amounts) Three Months Ended September 30, Nine Months Ended September 30, 2026 2025 2026 2025 Revenue, net (includes $ 3.8 million and $ 12.2 million with related parties for the three months ended September 30, 2026 and 2025, respectively, and $ 15.8 million and $ 42.9 million with related parties for the nine months ended September 30, 2026 and 2025, respectively) $ 716,000 $ 659,903 $ 2,129,935 $ 1,821,784 Operating expenses: Direct service costs, excluding depreciation and amortization 204,851 186,335 605,680 549,977 Reimbursed out-of-pocket expenses 287,264 276,629 902,407 716,505 Total direct costs 492,115 462,964 1,508,087 1,266,482 Selling, general and administrative 51,765 48,082 147,785 152,643 Depreciation 6,425 6,813 19,731 20,284 Amortization 155 236 465 709 Total operating expenses 550,460 518,095 1,676,068 1,440,118 Income from operations 165,540 141,808 453,867 381,666 Other income, net: Miscellaneous income (expense), net 17 ( 489 ) 841 ( 5,180 ) Interest income, net 5,349 1,517 15,452 9,058 Total other income, net 5,366 1,028 16,293 3,878 Income before income taxes 170,906 142,836 470,160 385,544 Income tax provision 33,446 31,701 87,468 69,554 Net income $ 137,460 $ 111,135 $ 382,692 $ 315,990 Net income per share attributable to common shareholders: Basic $ 4.92 $ 3.95 $ 13.58 $ 10.88 Diluted $ 4.84 $ 3.86 $ 13.37 $ 10.64 Weighted average common shares outstanding: Basic 27,940 28,136 28,184 29,033 Diluted 28,372 28,817 28,630 29,710 See notes to condensed consolidated financial statements. -4- Table of Contents MEDPACE HOLDINGS, INC. AND SUBSIDIARIES CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (UNAUDITED) (Amounts in thousands) Three Months Ended September 30, Nine Months Ended September 30, 2026 2025 2026 2025 Net income $ 137,460 $ 111,135 $ 382,692 $ 315,990 Other comprehensive (loss) income Foreign currency translation adjustments, net of taxes ( 817 ) 2 ( 2,993 ) 9,091 Comprehensive income $ 136,643 $ 111,137 $ 379,699 $ 325,081 See notes to condensed consolidated financial statements. -5- Table of Contents MEDPACE HOLDINGS, INC. AND SUBSIDIARIES CONDENSED CONSOLIDATED STATEMENTS OF SHAREHOLDERS' EQUITY (UNAUDITED) (Amounts in thousands) Common Stock Treasury Stock Additional Paid-In Capital Retained Earnings (Accumulated Deficit) Accumulated Other Comprehensive Loss Total BALANCE — December 31, 2024 $ 306 $ ( 12,235 ) $ 844,050 $ 8,167 $ ( 14,743 ) $ 825,545 Net income 114,595 114,595 Foreign currency translation 3,122 3,122 Stock-based compensation expense 16,892 16,892 Stock options exercised 4 25,941 25,945 Repurchases of common stock ( 12 ) ( 392,478 ) ( 392,490 ) BALANCE — March 31, 2025 $ 298 $ ( 12,235 ) $ 886,883 $ ( 269,716 ) $ ( 11,621 ) $ 593,609 Net income 90,260 90,260 Foreign currency translation 5,967 5,967 Stock-based compensation expense 5,951 5,951 Stock options exercised 340 340 Repurchases of common stock ( 17 ) ( 523,759 ) ( 523,776 ) BALANCE — June 30, 2025 $ 281 $ ( 12,235 ) $ 893,174 $ ( 703,215 ) $ ( 5,654 ) $ 172,351 Net income 111,135 111,135 Foreign currency translation 2 2 Stock-based compensation expense 6,323 6,323 Stock options exercised 1 7,986 7,987 Repurchases of common stock ( 4,157 ) ( 4,157 ) BALANCE — September 30, 2025 $ 282 $ ( 12,235 ) $ 907,483 $ ( 596,237 ) $ ( 5,652 ) $ 293,641 Common Stock Treasury Stock Additional Paid-In Capital Accumulated Deficit Accumulated Other Comprehensive Loss Total BALANCE — December 31, 2025 $ 284 $ ( 12,156 ) $ 935,830 $ ( 459,981 ) $ ( 4,906 ) $ 459,071 Net income 123,870 123,870 Foreign currency translation ( 2,215 ) ( 2,215 ) Stock-based compensation expense 4,918 4,918 Stock options exercised 2 12,668 12,670 BALANCE — March 31, 2026 $ 286 $ ( 12,156 ) $ 953,416 $ ( 336,111 ) $ ( 7,121 ) $ 598,314 Net income 121,362 121,362 Foreign currency translation 39 39 Stock-based compensation expense 4,348 4,348 Stock options exercised 5 6,419 6,424 Repurchases of common stock ( 7 ) ( 296,619 ) ( 296,626 ) BALANCE — June 30, 2026 $ 279 $ ( 12,151 ) $ 964,183 $ ( 511,368 ) $ ( 7,082 ) $ 433,861 Net income 137,460 137,460 Foreign currency translation ( 817 ) ( 817 ) Stock-based compensation expense 7,604 7,604 Stock options exercised 1 6,495 6,496 Repurchases of common stock 335 335 BALANCE — September 30, 2026 $ 280 $ ( 12,151 ) $ 978,282 $ ( 373,573 ) $ ( 7,899 ) $ 584,939 See notes to condensed consolidated financial statements. -6- Table of Contents MEDPACE HOLDINGS, INC. AND SUBSIDIARIES CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (UNAUDITED) (Amounts in thousands) Nine Months Ended September 30, 2026 2025 CASH FLOWS FROM OPERATING ACTIVITIES: Net income $ 382,692 $ 315,990 Adjustments to reconcile net income to net cash provided by operating activities: Depreciation 19,731 20,284 Amortization 465 709 Stock-based compensation expense 16,870 29,166 Noncash lease expense 18,063 17,329 Deferred income tax provision 28,220 63,366 Other 669 ( 433 ) Changes in assets and liabilities: Accounts receivable and unbilled, net ( 45,148 ) ( 77,119 ) Prepaid expenses and other current assets ( 2,576 ) ( 15,607 ) Accounts payable 1,469 1,296 Accrued expenses 36,101 57,521 Advanced billings 107,465 123,743 Lease liabilities ( 17,807 ) ( 18,131 ) Other assets and liabilities, net ( 15,818 ) 2,457 Net cash provided by operating activities 530,396 520,571 CASH FLOWS FROM INVESTING ACTIVITIES: Property and equipment expenditures ( 50,886 ) ( 26,820 ) Other 115 153 Net cash used in investing activities ( 50,771 ) ( 26,667 ) CASH FLOWS FROM FINANCING ACTIVITIES: Proceeds from stock option exercises 25,590 34,272 Repurchases of common stock ( 294,764 ) ( 917,389 ) Net cash used in financing activities ( 269,174 ) ( 883,117 ) EFFECT OF EXCHANGE RATES ON CASH AND CASH EQUIVALENTS ( 2,185 ) 5,128 INCREASE (DECREASE) IN CASH AND CASH EQUIVALENTS 208,266 ( 384,085 ) CASH AND CASH EQUIVALENTS — Beginning of period 497,049 669,436 CASH AND CASH EQUIVALENTS — End of period $ 705,315 $ 285,351 See notes to condensed consolidated financial statements. -7- Table of Contents MEDPACE HOLDINGS, INC. AND SUBSIDIARIES NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (UNAUDITED) September 30, 2026 (1) Basis of Presentation Description of Business Medpace Holdings, Inc. (together with its subsidiaries, “Medpace” or the “Company”), a Delaware corporation, is a global provider of clinical research-based drug and medical device development services. The Company partners with pharmaceutical, biotechnology, and medical device companies in the development and execution of clinical trials. The Company’s drug development services focus on full service Phase I-IV clinical development services and include development plan design, project management, regulatory affairs, clinical monitoring, data management and analysis, pharmacovigilance new drug application submissions, post-marketing clinical support, laboratory services, clinical human pharmacology, imaging services, and electrocardiography reading support for clinical trials. The Company’s operations are principally based in North America, Europe, and Asia. Unaudited Interim Financial Information The interim condensed consolidated financial statements include the accounts of the Company, are prepared in conformity with U.S. generally accepted accounting principles (“GAAP”), and are unaudited. In the opinion of the Company’s management, all adjustments of a normal recurring nature necessary for a fair presentation have been reflected. Certain financial information that is normally included in annual financial statements prepared in accordance with GAAP, but that is not required for interim reporting purposes, has been omitted. The preparation of the interim condensed consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the interim condensed consolidated financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results and outcomes could differ from management’s estimates and assumptions. As such, the information included in this quarterly report on Form 10-Q should be read in conjunction with the Company’s audited consolidated financial statements and related notes included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2025. Share Repurchases In 2022, the Company’s Board of Directors (the “Board”) approved a share repurchase program which has been amended several times to increase the aggregate amount of the share repurchase authorization. The Company did not execute any share repurchases during the three months ended September 30, 2026. During the nine months ended September 30, 2026, the Company repurchased 705,616 shares for $ 294.7 million. During the three and nine months ended September 30, 2025, the Company repurchased 14,649 shares and 2,961,924 shares for $ 4.5 million and $ 912.9 million, respectively. As of September 30, 2026, the Company has remaining authorization of $ 527.0 million under the repurchase program. Effective October 20, 2026, the Board approved the termination of the current share repurchase authorization and approved a new share repurchase authorization of up to $ 1.0 billion. Repurchases under the share repurchase program are executed in the open market or negotiated transactions under trading plans put in place pursuant to Rule 10b5-1. The Company constructively retired the repurchased shares associated with these approved share repurchases, except for a small portion which were retained as Treasury Shares on the condensed consolidated statements of shareholders' equity. Retired share repurchase amounts paid in excess of par value are reflected within Accumulated deficit/Retained earnings in the Company’s condensed consolidated balance sheets. Recently Issued Accounting Pronouncements In November 2024, the FASB issued ASU 2024-03, “Income Statement-Reporting Comprehensive Income-Expense Disaggregation Disclosures (Subtopic 220-40): Disaggregation of Income Statement Expenses” to improve disclosures by providing more detailed information about the types of expenses in commonly presented expense captions. The guidance is effective for annual reporting periods beginning after December 15, 2026, and interim periods within fiscal years beginning -8- Table of Contents after December 15, 2027, with early adoption permitted. The Company is currently evaluating the effect this standard will have on its consolidated financial statements and related disclosures. In September 2025, the FASB issued ASU 2025-06, “Intangibles-Goodwill and Other-Internal-Use Software (Subtopic 350-40): Targeted Improvements to the Accounting for Internal-Use Software” to modernize the accounting for software development costs and specify disclosure requirements. The guidance is effective for annual periods beginning after December 15, 2027, and interim reporting periods within those annual reporting periods, with early adoption permitted as of the beginning of an annual reporting period. The Company is currently evaluating the effect this standard will have on its consolidated financial statements and related disclosures. In December 2025, the FASB issued ASU 2025-10, "Government Grants (Topic 832): Accounting for Government Grants Received by Business Entities" which establishes authoritative US GAAP guidance for accounting for grants received for consistency in applying the accounting rules across business entities. The guidance is effective for annual reporting periods beginning after December 15, 2028, and interim reporting periods within those annual reporting periods, with early adoption permitted. The Company is currently evaluating the effect this standard will have on its consolidated financial statements and related disclosures. (2) Net Income Per Share Basic and diluted earnings or loss per share (“EPS”) are computed using the two-class method, which is an earnings allocation that determines EPS for each class of common stock and participating securities according to dividends declared and participation rights in undistributed earnings. The Company’s Restricted Stock Awards (“RSA”) are considered participating securities because they are legally issued at the date of grant and holders are entitled to receive non-forfeitable dividends during the vesting term. The computation of diluted EPS includes additional common shares, such as unvested Restricted Stock Units (“RSU”) and stock options with exercise prices less than the average market price of the Company’s common stock during the period (“in-the-money options”), which would be considered outstanding. This assumes that additional shares would have to be issued in cases where the exercise price of stock options is less than the value of the common stock being acquired because the cash proceeds received from the stock option holder would not be sufficient to acquire that same number of shares. The Company does not compute diluted EPS in cases where the inclusion of such additional shares would be anti-dilutive in effect. The following table sets forth the computation of basic and diluted earnings per share for the three and nine months ended September 30, 2026 and 2025 (in thousands, except for earnings per share): Three Months Ended September 30, Nine Months Ended September 30, 2026 2025 2026 2025 Numerator: Net income available to common shareholders $ 137,460 $ 111,135 $ 382,692 $ 315,990 Denominator: Basic weighted-average common shares outstanding 27,940 28,136 28,184 29,033 Effect of diluted shares 432 681 446 677 Diluted weighted-average common shares outstanding 28,372 28,817 28,630 29,710 Earnings per common share: Net income per common share—Basic $ 4.92 $ 3.95 $ 13.58 $ 10.88 Net income per common share—Diluted $ 4.84 $ 3.86 $ 13.37 $ 10.64 For the three and nine months ended September 30, 2026, the computation of diluted EPS excludes the effect of (in thousands) 0.5 and 2.4 stock options, respectively, due to each respective period’s average fair value of the Company’s common stock not exceeding the exercise prices. For the nine months ended September 30, 2025, the computation of diluted EPS excludes the effect of (in thousands) 78.1 stock options due to the period’s average fair value of the Company’s common stock not exceeding the exercise prices. -9- Table of Contents (3) Fair Value Measurements The Company follows accounting guidance related to fair value measurements that defines fair value, establishes a framework for measuring fair value, and establishes a hierarchy for inputs used in measuring fair value. This hierarchy maximizes the use of “observable” inputs and minimizes the use of unobservable inputs by requiring that the most observable inputs be used when available. The hierarchy specifies three levels based on the inputs, as follows: Level 1: Valuations based on quoted prices in active markets for identical assets or liabilities. Level 2: Valuations based on directly observable inputs or unobservable inputs corroborated by market data. Level 3: Valuations based on unobservable inputs supported by little or no market activity representing management’s determination of assumptions of how market participants would price the assets or liabilities. The fair value of financial instruments such as cash and cash equivalents, accounts receivable and unbilled, net, accounts payable, accrued expenses and advanced billings approximate their carrying amounts due to their short term maturities. The Company does not have material recurring fair value measurements as of September 30, 2026 and December 31, 2025. There were no material transfers between Level 1, Level 2 or Level 3 during the three and nine months ended September 30, 2026 and 2025. (4) Contract Assets and Contract Liabilities Contract assets and liabilities are reflected in the Company’s condensed consolidated balance sheets within the accounts reflected below. Contract Assets Accounts receivable represent amounts due from the Company’s customers who are concentrated primarily in the pharmaceutical, biotechnology, and medical device industries. Unbilled represents revenue recognized to date that has not been billed or is not yet contractually billable to the customer. In general, amounts become billable upon the achievement of negotiated contractual events, in accordance with predetermined payment schedules or when a reimbursable expense has been incurred. Amounts classified to unbilled are those billable to customers within one year from the respective balance sheet date. Accounts receivable and unbilled, net consisted of the following (in thousands): As of September 30, 2026 December 31, 2025 Accounts receivable $ 419,841 $ 376,755 Unbilled receivables 27,829 25,352 Less: allowance for doubtful accounts ( 28 ) ( 29 ) Total accounts receivable and unbilled, net $ 447,642 $ 402,078 Contract Liabilities Advanced billings represent cash received from customers, or billed amounts per an agreed upon payment schedule, in advance of services being performed or revenue being recognized. Advanced billings consisted of the following (in thousands): As of September 30, 2026 December 31, 2025 Advanced billings $ 961,855 $ 854,390 As of September 30, 2026 and December 31, 2025, the Company had approximately $ 3.8 billion and $ 3.6 billion of performance obligations remaining to be performed for active projects. -10- Table of Contents (5) Intangible Assets, Net Intangible assets, net consisted of the following (in thousands): As of September 30, 2026 December 31, 2025 Intangible assets: Finite-lived intangible assets: Carrying amount: Customer relationships $ 145,051 $ 145,051 Accumulated amortization: Customer relationships ( 143,742 ) ( 143,277 ) Total finite-lived intangible assets, net 1,309 1,774 Trade name (indefinite-lived) 31,646 31,646 Total intangible assets, net $ 32,955 $ 33,420 As of September 30, 2026, estimated amortization expense of the Company’s intangible assets for each of the remaining years is as follows (in thousands): Amortization Remainder of 2026 $ 155 2027 577 2028 577 $ 1,309 (6) Accrued Expenses Accrued expenses consisted of the following (in thousands): As of September 30, 2026 December 31, 2025 Employee compensation and benefits $ 98,471 $ 80,139 Project related reimbursable expenses 329,944 316,013 Other 14,916 12,230 Total accrued expenses $ 443,331 $ 408,382 (7) Debt On September 30, 2019, the Company entered into a Loan Agreement (as it may be amended from time to time, the “Loan Agreement”) providing for an unsecured credit facility (as amended from time to time, the “Credit Facility”) through its wholly owned subsidiaries, Medpace, Inc., as borrower (the “Borrower”), and Medpace IntermediateCo, Inc., as guarantor (the “Guarantor”). At the same time the Company entered into the Loan Agreement, the Guarantor executed a Guaranty Agreement providing for its guarantee of the payment and performance of the obligations under the Loan Agreement. On July 17, 2025, the Company entered into Amendment No. 9 to the Loan Agreement, which changed the aggregate principal amount that may be borrowed under the Credit Facility to up to $ 10.0 million. The Credit Facility expires April 30, 2027 and bears interest at a rate of the sum of The Secured Overnight Financing Rate (SOFR) plus 100 basis points ( 1.00 %) or the highest of the Prime Rate, the sum of the Overnight Bank Funding Rate plus 50 basis points ( 0.50 %) and the sum of Daily Simple SOFR plus 100 basis points ( 1.00 %). As of September 30, 2026 and December 31, 2025, the Company had no indebtedness under the Credit Facility. -11- Table of Contents The Loan Agreement contains other customary loan terms, representations and warranties, and affirmative and negative covenants, in each case, subject to customary limitations, exceptions and exclusions. The Loan Agreement contains certain events of default, including, among others, non-payment of principal or interest and breach of the covenants. (8) Leases The Company enters into leases for real estate and equipment. Real estate leases are for our corporate office space and laboratories around the world. Real estate leases have remaining lease terms of less than 1 year to 15 years. Many of the Company’s leases include options to extend the leases on a month to month basis or for set periods for up to 20 years. Many leases also include options to terminate the leases within 1 year or per other contractual terms. The components of lease expense were as follows (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2026 2025 2026 2025 Operating lease cost $ 8,144 $ 7,672 $ 23,927 $ 23,425 Variable lease cost $ 3,432 $ 3,282 $ 10,252 $ 9,113 Supplemental cash flow information related to the leases was as follows (in thousands): Nine Months Ended September 30, 2026 2025 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 18,537 $ 18,738 Right-of-use assets obtained in exchange for lease obligations: Operating leases $ 53,331 $ 8,285 Supplemental balance sheet information related to the leases was as follows (in thousands): As of September 30, 2026 December 31, 2025 Operating lease right-of-use assets - related parties $ 90,550 $ 68,416 Operating lease right-of-use assets - non-related parties 61,999 49,399 Operating lease right-of-use assets $ 152,549 $ 117,815 Other current liabilities - related parties 6,609 6,915 Other current liabilities - non-related parties 18,808 16,294 Other current liabilities $ 25,417 $ 23,209 Operating lease liabilities - related parties 99,233 77,344 Operating lease liabilities - non-related parties 46,808 36,299 Operating lease liabilities 146,041 113,643 Total operating lease liabilities $ 171,458 $ 136,852 Weighted Average Remaining Lease Term (years) Operating leases 9.3 9.1 Weighted Average Discount Rate Operating leases 5.7 % 5.7 % -12- Table of Contents Lease payments due related to lease liabilities as of September 30, 2026 were as follows (in thousands): Related Party Operating Leases Non-Related Parties Operating Leases Total Operating Leases Remainder of 2026 $ 3,238 $ 5,313 $ 8,551 2027 12,526 20,172 32,698 2028 12,198 15,605 27,803 2029 12,413 12,059 24,472 2030 12,634 7,251 19,885 Later years 98,027 14,250 112,277 Total lease payments 151,036 74,650 225,686 Less: imputed interest ( 45,194 ) ( 9,034 ) ( 54,228 ) Total $ 105,842 $ 65,616 $ 171,458 As of September 30, 2026, we have an additional lease with contractual obligations, which have not yet commenced , with future payments of $ 0.4 million. (9) Shareholders’ Equity and Stock-Based Compensation The Company granted 214,526 awards to employees under the 2016 Amended and Restated Incentive Award Plan during the nine months ended September 30, 2026, consisting of 111,158 RSU and 58,368 stock options having five year vesting schedules and 15,000 RSU and 30,000 stock options having two year vesting schedules. The Company granted an additional 6,660 stock option awards to non-employee directors under the 2016 Amended and Restated Incentive Award Plan during the nine months ended September 30, 2026. These awards are scheduled to vest on the earlier of (a) the day immediately preceding the date of the first annual meeting following the date of grant and (b) the first anniversary of the date of grant, subject to the non-employee director continuing in service through the applicable vesting date. Award Activity The following table sets forth the Company’s stock option activity: Nine Months Ended September 30, 2026 Stock Options Weighted Average Exercise Price Outstanding - beginning of period 618,681 $ 211.29 Granted 95,028 $ 414.20 Exercised ( 183,475 ) $ 140.22 Cancelled/Forfeited/Expired ( 11,643 ) $ 331.92 Outstanding - end of period 518,591 $ 271.17 Exercisable - end of period 377,943 $ 225.74 -13- Table of Contents The following table sets forth the Company’s RSA/RSU activity: Nine Months Ended September 30, 2026 Shares/Units Outstanding and unvested - beginning of period 324,517 Granted 126,158 Vested ( 118,335 ) Forfeited ( 26,285 ) Outstanding and unvested - end of period 306,055 Stock-based compensation expense recognized in the condensed consolidated statements of operations related to all outstanding stock-based compensation awards is summarized below (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2026 2025 2026 2025 Total direct costs $ 3,306 $ 3,772 $ 9,121 $ 10,219 Selling, general and administrative 4,298 2,551 7,749 18,947 Total stock-based compensation expense $ 7,604 $ 6,323 $ 16,870 $ 29,166 (10) Income Taxes The Company’s effective income tax rate was 19.6 % and 22.2 % for the three months ended September 30, 2026 and 2025, respectively. The Company's effective income tax rate was 18.6 % and 18.0 % for the nine months ended September 30, 2026 and 2025, respectively. The Company’s effective income tax rate for the three months ended September 30, 2026 varied from the U.S. statutory rate of 21 % primarily due to the impact of the state taxes which was favorably offset by excess tax benefits recognized from share-based compensation and tax benefits related to Foreign Derived Deduction Eligible Income. The Company’s effective income tax rate for the nine months ended September 30, 2026 varied from the U.S. statutory rate of 21 % due to the impact of state taxes, which was favorably offset by excess tax benefits recognized from share-based compensation and tax benefits related to Foreign Derived Deduction Eligible Income. On July 4, 2025, the One Big Beautiful Bill Act (“OBBBA”) was enacted in the U.S. The OBBBA includes significant provisions, such as the permanent extension of certain expiring provisions of the Tax Cuts and Jobs Act, modifications to the international tax framework and the restoration of favorable tax treatment for certain business provisions. Where relevant, the Company has reflected any material items that were enacted in the condensed consolidated financial statements for the three and nine months ended September 30, 2026 and 2025. (11) Commitments and Contingencies Legal Proceedings The Company is involved in legal proceedings from time to time in the ordinary course of its business, including employment claims and claims related to other business transactions. The Company cannot predict with certainty the outcome of such proceedings, but it believes that adequate reserves have been recorded and losses already recognized with respect to such proceedings, which were immaterial as of September 30, 2026 and December 31, 2025. There is a reasonable possibility that a loss exceeding amounts already recognized may be incurred related to these actions; however, the Company believes that such potential losses were immaterial as of September 30, 2026. On April 6, 2026, Jan Durbin filed a class action complaint in the United States District Court for the Southern District of Ohio (Case No. 1:26-cv-00346-MB) against Medpace Holdings, Inc., August J. Troendle, Jesse J. Geiger, and Kevin M. Brady alleging violations of Sections 10(b) and 20(a) of the Securities Exchange Act of 1934 (“Exchange Act”) and Rule 10b-5 promulgated under Section 10(b). Plaintiff alleges that defendants made materially false and misleading statements related to the Company’s book-to-bill ratio to deceive the market in violation of the Exchange Act. Plaintiff seeks unspecified damages, interest, attorneys’ fees, expert fees and other costs. On October 12, 2026, the plaintiff filed a notice of voluntary dismissal, without prejudice, against the defendants. -14- Table of Contents On June 22, 2026, Stephen Bushansky filed a complaint in the United States District Court for the Southern District of Ohio (Case No. 1:26-cv-617) purporting to bring a stockholder derivative action on behalf of the Company against the Company and certain of its current and past officers and directors, namely August J. Troendle, Jesse J. Geiger, Kevin M. Brady, Susan E. Burwig, Stephen P. Ewald, Brian T. Carley, Fred B. Davenport, Jr., Femida H. Gwadry-Sridhar, Robert O. Kraft, Cornelius P. “Neal” McCarthy III, and Dani Zander in connection with the Company’s statements related to its book-to-bill ratio. Plaintiff alleges that the director defendants violated Section 14(a) of the Exchange Act and Rule 14a-9 thereunder and are also liable under Section 21D of the Exchange Act which governs the application of any private right of action for contribution asserted pursuant to the federal securities laws. Plaintiff also alleges claims under state law, asserting that defendants breached fiduciary duties, aided and abetted breaches of fiduciary duties and were unjustly enriched. Plaintiff seeks unspecified damages, restitution, disgorgement of profits and other relief. On October 20, 2026, the plaintiff filed a notice of voluntary dismissal, without prejudice, against the defendants. On August 25, 2026, Stephen J. Mary filed a complaint in the United States District Court for the Southern District of Ohio (Case No. 1:26-cv-865) purporting to bring a stockholder derivative action on behalf of the Company against the Company and certain of its current and past officers and directors, namely August J. Troendle, Jesse J. Geiger, Kevin M. Brady, Susan E. Burwig, Stephen P. Ewald, Brian T. Carley, Fred B. Davenport, Jr., Femida H. Gwadry-Sridhar, Robert O. Kraft, Cornelius P. “Neal” McCarthy III, and Dani Zander in connection with the Company’s statements related to its book-to-bill ratio. Plaintiff alleges that the defendants breached their fiduciary duties by issuing and failing to correct materially false and/or misleading statements and omissions of material fact to the investing public. Plaintiff’s claims against defendants allege violations of Section 14(a) of the Exchange Act, breach of fiduciary duty, aiding and abetting breach of fiduciary duty, unjust enrichment, waste of corporate assets, and contribution. Plaintiff seeks unspecified damages, restitution, disgorgement of profits and other relief. On October 20, 2026, the plaintiff filed a notice of voluntary dismissal, without prejudice, against the defendants. Purchase Commitments The Company has several minimum purchase commitments for project related supplies and support services totaling $ 26.1 million as of September 30, 2026. In return for the commitment, Medpace receives preferential pricing. The commitments expire at various times through 2030. (12) Related Party Transactions Employee Loans The Company periodically extends short term loans or advances to employees, typically upon commencement of employment. Total receivables as a result of these employee advances of $ 0.4 million existed at September 30, 2026 and December 31, 2025, and are included in the Prepaid expenses and other current assets and Other assets line items of the condensed consolidated balance sheets, respectively, depending on the contractual repayment date. Service Agreement LIB Therapeutics LLC and subsidiaries (“LIB”) Certain executives and employees of the Company, including the chief executive officer, are members of LIB’s board of managers. The Company entered into a MSA dated November 24, 2015 with LIB, a company that engages in research, development, marketing and commercialization of pharmaceutical drugs. Subsequently, the Company and LIB have entered into several task orders for the Company to perform clinical trial related services. The Company recognized total revenue from LIB of $ 1.6 million and $ 1.8 million during the three months ended September 30, 2026 and 2025, respectively, and $ 4.0 million and $ 5.7 million during the nine months ended September 30, 2026 and 2025, respectively, in the Company’s condensed consolidated statements of operations. As of September 30, 2026 and December 31, 2025, the Company had Advanced billings from LIB of $ 9.0 million and $ 8.1 million, respectively, in the condensed consolidated balance sheets. As of September 30, 2026 and December 31, 2025 the Company had Accounts receivable and unbilled, net from LIB of $ 2.9 million and $ 1.9 million, respectively, in the condensed consolidated balance sheets. CinRX Pharma, subsidiaries and affiliates (“CinRx”) Certain executives and employees of the Company, including the chief executive officer, are members of CinRx’s board of managers and/or have equity investments in CinRx, a biotech company. The Company and CinRx have entered into several task orders for the Company to perform clinical trial related services. The Company recognized total revenue from CinRx of $ 2.3 million and $ 10.4 million during the three months ended September 30, 2026 and 2025, respectively, and $ 11.9 million and $ 37.2 million during the nine months ended September 30, 2026 and 2025, respectively, in the Company’s condensed consolidated statements of operations. As of September 30, 2026 and December 31, 2025, the Company had -15- Table of Contents Advanced billings from CinRx of $ 3.2 million and $ 4.3 million, respectively, in the condensed consolidated balance sheets. As of September 30, 2026 and December 31, 2025 the Company had Accounts receivable and unbilled, net from CinRx of less than $ 0.1 million and $ 1.6 million, respectively, in the condensed consolidated balance sheets. The Summit Hotel (“The Summit”) The Summit Hotel, located on the Medpace campus, is owned by the chief executive officer, and managed by an unrelated hospitality management entity. Medpace incurs travel lodging and meeting expenses at The Summit. Medpace incurred expenses of $ 0.1 million during the three months ended September 30, 2026 and 2025, and $ 0.2 million during the nine months ended September 30, 2026 and 2025, at The Summit. Leased Real Estate Campus Headquarters Leases The Company entered into an operating lease for the occupancy of office space in a building in Cincinnati, Ohio with an entity that is wholly owned by the chief executive officer of the Company. The Company has evaluated its relationship with the related party and concluded that the related party is not a variable interest entity because the Company has no direct ownership interest or relationship other than the lease. The lease was renewed in the first quarter of fiscal year 2023 for a term of ten years through 2032 with a renewal option for one 10-year term at prevailing market rates. The Company pays rent, taxes, insurance, and maintenance expenses that arise from the use of the property. Annual base rent for its corporate headquarters allows for adjustments to the rental rate annually for increases in the consumer price index. The Company has determined that the lease is an operating lease. Operating lease cost recognized for the three months ended September 30, 2026 and 2025 was $ 0.7 million. Operating lease cost recognized for the nine months ended September 30, 2026 and 2025 was $ 2.1 million. The operating lease cost was allocated between Total direct costs and Selling, general and administrative in the condensed consolidated statements of operations. The Operating lease right-of-use assets at September 30, 2026 and December 31, 2025 were $ 14.4 million and $ 15.8 million, respectively, in the condensed consolidated balance sheets. The current and long-term portions of the lease liabilities at September 30, 2026 were $ 1.9 million and $ 13.2 million, respectively, and were recognized in Other current liabilities and Operating lease liabilities in the condensed consolidated balance sheets. The current and long-term portions of the lease liabilities at December 31, 2025 were $ 1.8 million and $ 14.7 million, respectively, and were recognized in Other current liabilities and Operating lease liabilities in the condensed consolidated balance sheets. In 2018, Medpace, Inc. entered into a multi-year lease agreement governing future occupancy of additional office space in Cincinnati, Ohio with an entity that is wholly owned by the Company’s chief executive officer and certain members of his immediate family. The Company began to occupy the premises in the second quarter of fiscal year 2020. The lease expires in 2040 and the Company has two 10 -year options to extend the term of the lease. The Company pays rent, taxes, insurance, and maintenance expenses that arise from the use of the property. Annual base rent for the corporate headquarters allows for adjustments to the rental rate annually for increases in the consumer price index. The Company has determined that the lease is an operating lease. Operating lease cost recognized for the three months ended September 30, 2026 and 2025 was $ 1.5 million. Operating lease cost recognized for the nine months ended September 30, 2026 and 2025 was $ 4.3 million. The operating lease cost was allocated between Total direct costs and Selling, general and administrative in the condensed consolidated statements of operations. The Operating lease right-of-use assets at September 30, 2026 and December 31, 2025 were $ 47.0 million and $ 48.4 million, respectively, in the condensed consolidated balance sheets. The current and long-term portions of the lease liabilities at September 30, 2026 were $ 2.0 million and $ 58.8 million, respectively, and were recognized in Other current liabilities and Operating lease liabilities in the condensed consolidated balance sheets. The current and long-term portions of the lease liabilities at December 31, 2025 were $ 1.8 million and $ 60.2 million, respectively and were recognized in Other current liabilities and Operating lease liabilities in the condensed consolidated balance sheets. The Company entered into a multi-year lease agreement governing the occupancy of office space in a building in Cincinnati, Ohio with an entity that is wholly owned by the Company’s chief executive officer and certain members of his immediate family. The lease was renewed in the third quarter of fiscal year 2026 for a term of ten years through 2037. The Company pays rent, taxes, insurance, and maintenance expenses that arise from the use of the property. Annual base rent for the corporate headquarters allows for adjustments to the rental rate annually for increases in the consumer price index. The Company has determined that the lease is an operating lease. Operating lease cost recognized for the three months ended September 30, 2026 and 2025 was $ 0.6 million. Operating lease cost recognized for the nine months ended September 30, 2026 and 2025 was $ 1.9 million. The operating lease cost was allocated between Total direct costs and Selling, general and administrative in the condensed consolidated statements of operations. The Operating lease right-of-use assets at September 30, 2026 and December 31, 2025 were $ 29.2 million and $ 4.2 million, respectively, in the -16- Table of Contents condensed consolidated balance sheets. The current and long-term portions of the lease liabilities at September 30, 2026 were $ 1.9 million and $ 27.2 million, respectively, and were recognized in Other current liabilities and Operating lease liabilities in the condensed consolidated balance sheets. The current and long-term portions of the lease liabilities at December 31, 2025 were $ 2.3 million and $ 1.9 million, respectively, and were recognized in Other current liabilities and Operating lease liabilities in the condensed consolidated balance sheets. The Company entered into a multi-year lease agreement governing the occupancy of office space in a building in Cincinnati, Ohio with an entity that is wholly owned by the Company’s chief executive officer and certain members of his immediate family. The Company assumed occupancy in 2012 and the lease expires in 2027 with the Company having one 10-year option to extend the lease term, which the Company did not exercise. In the first quarter of 2024, the Company reduced the lease term in connection with a plan to replace the leased office beginning in early 2025. The Company pays rent, taxes, insurance, and maintenance expenses that arise from the use of the property. Annual base rent for the corporate headquarters allows for adjustments to the rental rate annually for increases in the consumer price index. The Company has determined that the lease is an operating lease. Operating lease cost recognized for the three months ended September 30, 2026 and 2025 was less than $ 0.1 million. Operating lease cost recognized for the nine months ended September 30, 2026 and 2025 was $ 0.1 million and $ 0.8 million, respectively. The operating lease cost was allocated between Total direct costs and Selling, general and administrative in the condensed consolidated statements of operations. The current portion of the lease liability at September 30, 2026 was $ 0.8 million and was recognized in Other current liabilities in the condensed consolidated balance sheets. The current and long-term portions of the lease liabilities at December 31, 2025 were $ 1.0 million and $ 0.5 million, respectively, and were recognized in Other current liabilities and Operating lease liabilities in the condensed consolidated balance sheets. Travel Services The Company incurs expenses for travel services for company executives provided by a private aviation charter company controlled by the chief executive officer of the Company (“private aviation charter”). The Company may contract directly with the private aviation charter for the use of its aircraft or indirectly through a third party aircraft management and jet charter company (the “Aircraft Management Company”). The travel services provided are primarily for business purposes, with certain personal travel paid for as part of the executives’ compensation arrangements. The Aircraft Management Company also makes the private aviation charter aircraft available to third parties. The Company incurred travel expenses of $ 0.7 million and $ 0.5 million during the three months ended September 30, 2026 and 2025, respectively, and $ 1.5 million and $ 1.4 million during the nine months ended September 30, 2026 and 2025, respectively, related to these travel services. These travel expenses are recorded in Selling, general and administrative in the Company’s condensed consolidated statements of operations. As of September 30, 2026 and December 31, 2025, the Company had Accounts payable to the Aircraft Management Company of $ 0.1 million and $ 0.3 million, respectively, in the condensed consolidated balance sheets. -17- Table of Contents (13) Segment Disclosures Information about the one reportable segment, significant segment expenses and a reconciliation to condensed consolidated net income is as follows (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2026 2025 2026 2025 Revenue, net $ 716,000 $ 659,903 $ 2,129,935 $ 1,821,784 Operating expenses: Direct service costs, excluding depreciation and amortization - Employee compensation 165,451 149,295 493,143 441,164 Direct service costs, excluding depreciation and amortization - Other segment items (a) 39,400 37,040 112,537 108,813 Reimbursed out-of-pocket expenses 287,264 276,629 902,407 716,505 Total direct costs 492,115 462,964 1,508,087 1,266,482 Selling, general and administrative 51,765 48,082 147,785 152,643 Depreciation 6,425 6,813 19,731 20,284 Amortization 155 236 465 709 Total operating expenses 550,460 518,095 1,676,068 1,440,118 Income from operations 165,540 141,808 453,867 381,666 Other income, net: Miscellaneous income (expense), net 17 ( 489 ) 841 ( 5,180 ) Interest income, net 5,349 1,517 15,452 9,058 Total other income, net 5,366 1,028 16,293 3,878 Income before income taxes 170,906 142,836 470,160 385,544 Income tax provision 33,446 31,701 87,468 69,554 Segment net income $ 137,460 $ 111,135 $ 382,692 $ 315,990 Reconciliation of profit or loss Adjustments and reconciling items — — — — Condensed consolidated net income $ 137,460 $ 111,135 $ 382,692 $ 315,990 (a) Direct service costs, excluding depreciation and amortization - Other segment items includes costs related to inventory, leases, project subcontractors and other direct service costs. Revenue by Category The following table disaggregates the Company’s revenue by major source (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2026 2025 2026 2025 Therapeutic Area Metabolic $ 209,242 $ 199,256 $ 665,867 $ 495,144 Oncology 229,927 192,635 640,538 551,669 Other 99,955 106,398 291,552 320,296 Central Nervous System 83,649 65,627 246,714 181,657 Cardiology 61,409 59,470 177,652 176,333 AVAI 31,818 36,517 107,612 96,685 Total revenue $ 716,000 $ 659,903 $ 2,129,935 $ 1,821,784 -18- Table of Contents