Data as of Oct 28, 2026.
VOO vs XLV: Differences, Returns & Fees
Over the year to Oct 28, 2026, VOO returned +13.7% to XLV's +25.6%; 9% of their weight is in the same names.
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Net assets: $1.0tn on Sep 30, 2026 for Vanguard S&P 500 ETF, and $47.0bn on Oct 27, 2026 for State Street Health Care Select Sector SPDR ETF.
Pair scorecard
VOO costs 0.05 points a year less; their one-year returns differ by 11.9 points; VOO is far larger, $1.0tn against $43.4bn.
| Measure | VOO | XLV |
|---|---|---|
| Return | ||
| Total return, 1 year | +13.7% | +25.6% |
| Benchmark | ||
| What it tracks | S&P 500 Index | Health Care Select Sector Index |
| Cost and size | ||
| Expense ratio | 0.03% | 0.08% |
| Net assets, as of Sep 30, 2026 | $1.0tn | $43.4bn |
| Holdings | ||
| Holdings in common | 9% | |
| Top ten holdings, share of the fund | 39.1% | 60.6% |
Holdings in common uses holdings dated Sep 30, 2026 and Oct 27, 2026. Method
Risk and return
Sep 17, 2010 to Oct 23, 2026 · 840 weekly returnsVOO returned more: +804.0% to +685.0%. VOO and XLV swung about the same: 15.9% and 15.7%. XLV fell less at its worst: −24.3% to −31.8%.
Full scorecard
9 measures, with how each is measured Open ↓
| Measure | VOO | XLV | Edge | How it is measured |
|---|---|---|---|---|
| Return | ||||
| Total return | +804.0% | +685.0% | VOO | Price change plus distributions, reinvested. |
| Annualized | +14.6% | +13.6% | VOO (slight) | Total return as a yearly rate. |
| Price return | +575.9% | +498.8% | VOO | Price change alone, distributions left out. |
| Risk | ||||
| Volatility | 15.9% | 15.7% | Tie | Spread of weekly returns, annualized. Lower is steadier. |
| Downside deviation | 10.9% | 10.7% | Tie | Like volatility, counting only weeks below the Treasury bill rate. |
| Max drawdown | −31.8% | −24.3% | XLV | Deepest fall from a high to the low after it. |
| Risk-adjusted | ||||
| Sharpe | 0.84 | 0.79 | VOO (slight) | Return above Treasury bills per unit of volatility. |
| Sortino | 1.22 | 1.16 | VOO (slight) | Return above Treasury bills per unit of downside deviation. |
| Calmar | 0.46 | 0.56 | XLV | Annualized return divided by the max drawdown. |
Computed by ETFIQ from Tiingo daily prices and ETFIQ's distribution records, 840 weekly returns. Cash rate: the 13-week Treasury bill.
What they share
By the books each fund has filed, VOO and XLV hold 9% of their money in the same securities at the same weight. Holdings dated Sep 30, 2026 and Oct 27, 2026.
half
9% in common
Only in one fund ↓
Side by side
VOO and XLV on the fields both publish, as of Oct 28, 2026. Source: ETFIQ.
VOO and XLV do different jobs. What does each one do in a portfolio?
- What each follows. VOO follows S&P 500 Index and XLV follows Health Care Select Sector Index.
- Holdings in common. 9% of the weight is in the same securities (holdings dated Sep 30, 2026 and Oct 27, 2026).
- One-year total return. Over 1 year to Oct 28, 2026 VOO returned +13.7% and XLV +25.6% with distributions reinvested, a gap of 11.9 points.
Data as of Oct 28, 2026.
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VOO
VOO tracks the S&P 500. Over the year to Oct 28, 2026 it returned +13.7% with distributions reinvested, against +13.7% for its benchmark, the S&P 500 Index. The prospectus expense ratio is 0.03% a year. By its holdings published by its issuer as of Sep 30, 2026, 100% of the fund by weight is stocks the S&P 500 also holds, across 507 positions, with the top ten at 39.1%.
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, VOO or XLV?
- In the year to Oct 28, 2026, with distributions reinvested, VOO returned +13.7% and XLV +25.6%.
- Which is cheaper, VOO or XLV?
- VOO 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.
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ETFIQ, VOO against XLV, data as of Oct 28, 2026. https://etfiq.com/compare/any/voo-vs-xlv
ETFIQ. (Oct 28, 2026). VOO against XLV. Retrieved from https://etfiq.com/compare/any/voo-vs-xlv
[VOO against XLV (ETFIQ, Oct 28, 2026)](https://etfiq.com/compare/any/voo-vs-xlv)
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