Data as of Oct 28, 2026.
ITOT vs XLV: Differences, Returns & Fees
Over the year to Oct 28, 2026, ITOT returned +13.4% to XLV's +25.6%; 9% of their weight is in the same names.
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Net assets on Oct 27, 2026: $97.1bn for iShares Core S&P Total U.S. Stock Market ETF and $47.0bn for State Street Health Care Select Sector SPDR ETF.
Pair scorecard
ITOT costs 0.05 points a year less; their one-year returns differ by 12.2 points; ITOT is 2.1 times larger.
| Measure | ITOT | XLV |
|---|---|---|
| Return | ||
| Total return, 1 year | +13.4% | +25.6% |
| Benchmark | ||
| What it tracks | S&P Total Market Index (TMI) | Health Care Select Sector Index |
| Cost and size | ||
| Expense ratio | 0.03% | 0.08% |
| Net assets, as of Oct 27, 2026 | $97.1bn | $47.0bn |
| Holdings | ||
| Holdings in common | 9% | |
| Top ten holdings, share of the fund | 33.9% | 60.6% |
Holdings in common uses holdings dated Oct 27, 2026. Method
Risk and return
Jan 30, 2004 to Oct 23, 2026 · 1,186 weekly returnsITOT returned more: +886.3% to +745.7%. XLV swung slightly less: 16.1% to 17.3%. XLV fell less at its worst: −37.9% to −54.7%.
Full scorecard
9 measures, with how each is measured Open ↓
| Measure | ITOT | XLV | Edge | How it is measured |
|---|---|---|---|---|
| Return | ||||
| Total return | +886.3% | +745.7% | ITOT | Price change plus distributions, reinvested. |
| Annualized | +10.6% | +9.8% | ITOT (slight) | Total return as a yearly rate. |
| Price return | +567.2% | +478.7% | ITOT | Price change alone, distributions left out. |
| Risk | ||||
| Volatility | 17.3% | 16.1% | XLV (slight) | Spread of weekly returns, annualized. Lower is steadier. |
| Downside deviation | 12.2% | 11.3% | XLV (slight) | Like volatility, counting only weeks below the Treasury bill rate. |
| Max drawdown | −54.7% | −37.9% | XLV | Deepest fall from a high to the low after it. |
| Risk-adjusted | ||||
| Sharpe | 0.56 | 0.55 | Tie | Return above Treasury bills per unit of volatility. |
| Sortino | 0.80 | 0.78 | ITOT (slight) | Return above Treasury bills per unit of downside deviation. |
| Calmar | 0.19 | 0.26 | XLV | Annualized return divided by the max drawdown. |
Computed by ETFIQ from Tiingo daily prices and ETFIQ's distribution records, 1,186 weekly returns. Cash rate: the 13-week Treasury bill.
What they share
By the books each fund has filed, ITOT and XLV hold 9% of their money in the same securities at the same weight. Holdings dated Oct 27, 2026.
half
9% in common
Only in one fund ↓
Side by side
ITOT and XLV on the fields both publish, as of Oct 28, 2026. Source: ETFIQ.
ITOT and XLV do different jobs. What does each one do in a portfolio?
- What each follows. ITOT follows S&P Total Market Index (TMI) and XLV follows Health Care Select Sector Index.
- Holdings in common. 9% of the weight is in the same securities (holdings dated Oct 27, 2026).
- One-year total return. Over 1 year to Oct 28, 2026 ITOT returned +13.4% and XLV +25.6% with distributions reinvested, a gap of 12.2 points.
Data as of Oct 28, 2026.
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ITOT
ITOT tracks the S&P Total U.S. Stock Market. Over the year to Oct 28, 2026 it returned +13.4% with distributions reinvested. The prospectus expense ratio is 0.03% a year. By its holdings published by its issuer for Oct 27, 2026, 88% of the fund by weight is stocks the S&P 500 also holds, across 2,443 positions, with the top ten at 33.9%.
XLV
XLV tracks an index of Health care. Over the year to Oct 28, 2026 it returned +25.6% with distributions reinvested. The prospectus expense ratio is 0.08% a year. By its holdings published by its issuer for Oct 27, 2026, 100% of the fund by weight is stocks the S&P 500 also holds, across 62 positions, with the top ten at 60.6%.
Questions people ask
- Which returned more over the last year, ITOT or XLV?
- In the year to Oct 28, 2026, with distributions reinvested, ITOT returned +13.4% and XLV +25.6%.
- Which is cheaper, ITOT or XLV?
- ITOT is cheaper, by 0.05 percentage points a year. That is about $5 on $10,000 held for a year. Fees come from each fund's prospectus.
Links are sources, not endorsements. A comparison is not a recommendation.
How this is computed
Overlap adds up the smaller of the two weights for each security both funds hold.
Cite this pageCitation, APA and Markdown
ETFIQ, ITOT against XLV, data as of Oct 28, 2026. https://etfiq.com/compare/any/itot-vs-xlv
ETFIQ. (Oct 28, 2026). ITOT against XLV. Retrieved from https://etfiq.com/compare/any/itot-vs-xlv
[ITOT against XLV (ETFIQ, Oct 28, 2026)](https://etfiq.com/compare/any/itot-vs-xlv)
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