The art of M&A. This year's largest IPO in the U.S. stock market has arrived. Medline, a global healthcare company with a history spanning over 50 years, offers products ranging from surgical gloves to wheelchairs, face masks to thermometers. In 2021, a consortium led by Blackstone Group LP, alongside Carlyle and Hellman & Friedman, acquired a majority stake in the company from its founding family.
Four years later, under the push of shareholders like Blackstone, Medline has returned to the Nasdaq. The acquisition is now at its payoff moment—its market cap soared past $54 billion (approximately RMB 380 billion) on its debut, delivering substantial returns for the three PE firms. Rough estimates suggest potential paper gains of tens of billions for Blackstone and its peers.
**RMB 380 Billion: The Year’s Largest U.S. IPO** To understand Medline, one must first look at the mysterious Mills family behind it. Founded in 1966 by brothers Jim Mills and John Mills, Medline traces its roots to their grandfather, A.L. Mills, who ran a small sewing workshop in Chicago in 1910. From then on, the Mills family specialized in manufacturing aprons, surgical gowns, and uniforms.
By 1966, Jim and John officially launched Medline, inheriting a 185-square-meter warehouse and a loading dock from their grandfather. In its first year, the brothers generated $1 million in revenue solely from selling hospital gowns, bed sheets, and towels.
Medline briefly went public in 1972 but was privatized five years later due to sluggish stock performance. For the next five decades, it remained a family-run business. In 1997, after Jim Mills stepped down, the fourth generation took over—CEO Charlie Mills, President Andy Mills, and their brother-in-law Jim as COO.
Under their leadership, Medline expanded through acquisitions, evolving into a global healthcare leader. Today, it operates in over 100 countries, producing surgical gowns, gloves, masks, disinfectants, hospital beds, wheelchairs, and more.
The pandemic in 2020 propelled Medline’s growth as it supplied nursing homes, pharmacies, and hospitals. Sales surged 25.9% to $17.5 billion that year.
By 2024, Medline revisited its IPO plans. Late last year, reports emerged of its confidential SEC filing for a $5 billion+ offering, but market conditions delayed the public filing until last month. Last Wednesday night, Medline debuted on Nasdaq.
This IPO was a blockbuster—oversubscribed over 10 times, with 216 million shares priced at $29, raising $6.264 billion. Anchor investors, including Singapore’s GIC, committed $2.35 billion.
By proceeds, Medline is not only the largest U.S. IPO this year but also surpasses CATL’s $5.3 billion Hong Kong listing in May 2025 as the world’s biggest IPO. On its first day, shares surged 41%, closing at a $54 billion market cap (~RMB 380 billion).
Medline’s prospectus reveals uninterrupted annual sales growth since 1966, with an 18% CAGR—a rare feat in global markets. Investors’ enthusiasm suggests this rally may just be starting.
**Who Profited?** The biggest winners? Major shareholders include Blackstone, Carlyle, Hellman & Friedman, and the Mills family. This IPO also set a record as the largest PE-backed offering ever.
Four years ago, the Mills family initially planned a partial stake sale for liquidity. But the pandemic-driven M&A boom inflated valuations, changing their minds.
Soon, global PEs came knocking. Given Medline’s size, Blackstone, Carlyle, and Hellman & Friedman formed a consortium for an LBO, acquiring nearly 80% of the company.
Under PE ownership, Medline’s revenue grew nearly 50%, from $17.5 billion in 2020 to $25.5 billion in 2024. For the first nine months of 2025, revenue hit $20.6 billion, with net profit at $977 million.
PEs also facilitated a smooth transition to professional management. In 2023, 28-year veteran Jim Boyle became CEO—the first non-family member in the role.
Four years later, this deal stands as another Blackstone classic. Medline will use over 37 million shares’ proceeds to repurchase stock from pre-IPO shareholders, allowing Blackstone, Carlyle, and Hellman & Friedman to profit without direct sales.
Additionally, Medline pledged 90% of IPO-related tax benefits to certain pre-IPO shareholders, estimated at over $3.1 billion.
The real value lies in their holdings. At a $54 billion market cap, Medline’s value has risen over $20 billion in four years. Post-IPO, the Mills family holds 17.8% via Mozart Holdco, while Blackstone, Carlyle, and Hellman & Friedman each hold 18% voting rights and board seats. The consortium’s initial ~$17 billion investment now yields holdings worth tens of billions each.
This Monday, Medline disclosed insider transactions: Blackstone-affiliated Mozart Aggregator II LP sold ~13.46 million shares, cashing out ~$382 million.
**IPO Exit Season** Last quarter, Blackstone completed three IPOs: - July: Spanish gaming giant Cirsa listed on the Barcelona exchange at a €2.7 billion market cap. Blackstone’s 2017 buyout yielded over €2 billion in returns. - Knowledge Realty Trust debuted on the Mumbai exchange (~$5.4 billion market cap). - Specialty construction services firm Legence listed on Nasdaq (~$4.6 billion market cap), another Blackstone acquisition that doubled in value under its stewardship.
Blackstone’s Q3 earnings hinted at a potential record year for IPO volumes if its pipeline progresses.
Upcoming IPOs include Blackstone-controlled refrigeration firm Copeland, which confidentially filed for a 2026 debut. Acquired in 2023 at a $14 billion valuation, a successful listing would deliver yet another mega payday.
The long-awaited exit season has arrived.
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