# XLV ETF: fees, returns, drawdowns and holdings

> What XLV holds, its 0.08% yearly fee, returns by year, its worst drop, and which Tactfolio strategies hold it. Updated daily.

State Street Health Care Select Sector SPDR ETF (XLV) is an exchange-traded fund (ETF) run by SPDR (State Street). This fund owns stocks of the health care companies in the S&P 500, such as drug makers, medical device makers and health insurers. It charges 0.08% a year. From December 1998 to October 2026 it returned about 8.9% a year, and its worst drop was −39.2%.

Written by [the Tactfolio research team](https://tactfolio.com/about/editorial-policy). Fund facts checked October 16, 2026. Prices through October 16, 2026.

## Key points

- Expense ratio: 0.08% a year (about $8 on $10,000).
- Started trading on December 16, 1998.
- Worst drop since 1998: −39.2%.
- 1 Tactfolio classic strategy holds it.

## What does XLV hold?

This fund owns stocks of the health care companies in the S&P 500, such as drug makers, medical device makers and health insurers. It gives investors one ticker for that whole group. Its value goes up and down with that one part of the stock market.

It tracks the Health Care Select Sector Index. It had 61 holdings as of October 15, 2026, according to SPDR (State Street).

| Fact | XLV |
| --- | --- |
| Full name | State Street Health Care Select Sector SPDR ETF |
| Issuer | SPDR (State Street) |
| Expense ratio | 0.08% a year |
| Started trading | December 16, 1998 |
| Tracks | Health Care Select Sector Index |
| Type | US stocks, ETF |
| Holdings | 61 holdings as of October 15, 2026 |
| Facts checked | October 16, 2026 on the [SPDR (State Street) fund page](https://www.ssga.com/us/en/intermediary/etfs/state-street-health-care-select-sector-spdr-etf-xlv) |

## What is the XLV expense ratio?

XLV charges 0.08% a year. An expense ratio is the yearly fee a fund takes to run itself. On $10,000, a 0.08% fee comes to about $8 a year.

You never get a bill for it. The fund takes the fee out of its own value a little each day.

## How has XLV done since 1998?

From December 1998 to October 2026, XLV returned about 8.9% a year. Say you put in $10,000 at the start. It would have been worth about $106,117 at the end, with every dividend reinvested.

| Measure | XLV |
| --- | --- |
| Total return | 961.2% |
| Return per year (CAGR) | 8.9% |
| Worst drop from a high | −39.2% |
| Volatility (how much it swings) | 17.8% |
| Last 12 months | 26.2% |
| Last 3 years, per year | 12.3% |
| Last 5 years, per year | 8.4% |
| Last 10 years, per year | 11.6% |

Prices through October 16, 2026. Figures use daily closing prices adjusted for splits, with dividends reinvested. They do not include taxes or the cost of buying and selling. Past results do not tell you what will happen next.

## XLV returns by year

| Year | XLV return |
| --- | --- |
| 2026 (part of the year) | 15.6% |
| 2025 | 14.5% |
| 2024 | 2.5% |
| 2023 | 2.1% |
| 2022 | −2.1% |
| 2021 | 26.0% |
| 2020 | 13.3% |
| 2019 | 20.4% |
| 2018 | 6.3% |
| 2017 | 21.8% |
| 2016 | −2.8% |
| 2015 | 6.8% |
| 2014 | 25.1% |
| 2013 | 41.4% |
| 2012 | 17.4% |
| 2011 | 12.4% |
| 2010 | 3.3% |
| 2009 | 19.5% |
| 2008 | −23.3% |
| 2007 | 7.2% |
| 2006 | 7.0% |
| 2005 | 6.4% |
| 2004 | 1.3% |
| 2003 | 14.9% |
| 2002 | −0.7% |
| 2001 | −0.8% |
| 2000 | −11.8% |
| 1999 | 19.5% |
| 1998 (part of the year) | 3.9% |

## What was XLV's worst drop?

A drawdown is how far a fund falls from its last high point. XLV's worst fall was −39.2%, from December 10, 2007 to March 9, 2009. It got back to that high on April 26, 2011.

The chart shows how far below its last high the fund was on each day. Big drops are normal for some funds. They matter because selling during a drop locks in the loss.

## Which Tactfolio strategies hold XLV?

One classic strategy holds XLV at least some of the time. Each is a set of written rules you can open, test and copy.

- [Faber sector rotation (the three strongest US sectors)](https://tactfolio.com/strategies/faber-sector-rotation.md), by Mebane Faber, 2010

## How does XLV compare with similar ETFs?

Funds that can stand in for XLV:

- [VHT](https://tactfolio.com/etf/vht.md): Vanguard Health Care ETF, 0.09% a year
- [XLP](https://tactfolio.com/etf/xlp.md): State Street Consumer Staples Select Sector SPDR ETF, 0.08% a year
- [VDC](https://tactfolio.com/etf/vdc.md): Vanguard Consumer Staples ETF, 0.09% a year
- [QUAL](https://tactfolio.com/etf/qual.md): iShares MSCI USA Quality Factor ETF, 0.15% a year

See [all 5 XLV alternatives](https://tactfolio.com/alternatives/xlv.md), compared on the same dates as XLV.

## Test XLV in your own rules

Tactfolio is a platform where you build rules-based investing strategies, backtest them on decades of real prices, share them, and run them automatically in your own Alpaca account. Open the [builder](https://tactfolio.com/builder), add XLV, and see how a rule such as "hold it only above its 200-day average" would have done. Strategies run on daily prices and hold US stocks and ETFs only.

## The details

Prices come from Tactfolio's stored daily prices for XLV. Each close is adjusted for splits, and dividends are reinvested on the day the fund pays them out. CAGR is the steady yearly return that turns the starting value into the ending value. Volatility is the yearly standard deviation of daily returns.

Fund facts come from SPDR (State Street). We checked them on October 16, 2026. Read [what a backtest simulates](https://tactfolio.com/docs/backtests.md) and [how to read drawdown and CAGR](https://tactfolio.com/docs/concepts/reading-a-backtest.md) for more on these measures.

## Research and test it

- [Sector rotation](https://tactfolio.com/learn/sector-rotation): Sector rotation explained: the 11 GICS sectors and their ETFs, business-cycle vs momentum rotation, and a classic rule with dated backtest figures.
- [S&P 500 index](https://tactfolio.com/learn/sp500-index): The S&P 500 tracks about 500 large US companies. Learn how stocks get in, how the index is weighted, how to invest in it, and how far it has fallen before.
- [What is an ETF](https://tactfolio.com/learn/what-is-an-etf): An ETF is a fund that trades like a stock. Learn how ETFs work, what they cost, the main types, and the risks, with SEC sources.
- [ETF screener](https://tactfolio.com/screener.md): A free ETF screener for 162 US-listed funds. Filter by type, issuer and fee, sort by returns or worst drop, and compare funds side by side.
- [ETF expense ratio](https://tactfolio.com/learn/etf-expense-ratio): What an ETF expense ratio is, how the fund charges it, and how 0.03% vs 1% adds up over 10 and 30 years, with real fund examples.
- [Backtest a portfolio](https://tactfolio.com/trading-tools/backtest-portfolio): Backtest a portfolio of US stocks and ETFs. Enter tickers and shares, pick when to rebalance, and get the results with a link to share.

## Common questions

### What is the expense ratio of XLV?

XLV charges 0.08% a year, according to SPDR (State Street) as of October 16, 2026. That is about $8 a year for every $10,000 you hold.

### When did XLV start trading?

XLV started trading on December 16, 1998. It is run by SPDR (State Street).

### What does XLV track?

XLV tracks the Health Care Select Sector Index. This fund owns stocks of the health care companies in the S&P 500, such as drug makers, medical device makers and health insurers.

### How much has XLV returned per year?

From December 1998 to October 2026, XLV returned about 8.9% a year with dividends reinvested. Its worst drop was −39.2%. Past returns do not tell you what it will do next.

### Which strategies use XLV?

One of Tactfolio's classic strategies hold XLV, including Faber sector rotation (the three strongest US sectors).

## Sources

- [SPDR (State Street): State Street Health Care Select Sector SPDR ETF fund page](https://www.ssga.com/us/en/intermediary/etfs/state-street-health-care-select-sector-spdr-etf-xlv)

> Not financial advice. Tactfolio is a research and automation tool. It is not a broker or a financial adviser. This page is for education only. Backtests are hypothetical. They show how rules would have done on past prices, not how they will do. All investing involves risk, including losing the money you put in.