Data as of Oct 28, 2026.

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VTI vs XLV: Differences, Returns & Fees

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Over the year to Oct 28, 2026, VTI returned +13.5% to XLV's +25.6%; 8% of their weight is in the same names.

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Net assets: $689.2bn on Sep 30, 2026 for Vanguard Morningstar Total Stock Market ETF, and $47.0bn on Oct 27, 2026 for State Street Health Care Select Sector SPDR ETF.

At a glance
+13.5%
VTI total return, 1 year
+25.6%
XLV total return, 1 year
0.03%
VTI expense ratio
0.08%
XLV expense ratio

Pair scorecard

VTI costs 0.05 points a year less; their one-year returns differ by 12.1 points; VTI is 15.9 times larger.

VTI vs XLV: Differences, Returns & Fees
MeasureVTIXLV
Return
Total return, 1 year+13.5%+25.6%
Benchmark
What it tracksMorningstar US Total Market IndexHealth Care Select Sector Index
Cost and size
Expense ratio0.03%0.08%
Net assets, as of Sep 30, 2026$689.2bn$43.4bn
Holdings
Holdings in common8%
Top ten holdings, share of the fund34.7%60.6%

Holdings in common uses holdings dated Sep 30, 2026 and Oct 27, 2026. Method

Risk and return

Jun 8, 2001 to Oct 23, 2026 · 1,324 weekly returns
VTI XLV
Return
Total return edge VTI +898.9% +795.7%
Annualized edge VTI (slight) +9.5% +9.0%
Price return edge VTI (slight) +540.9% +499.6%
Risk
Volatility edge XLV (slight) 17.8% 16.7%
Max drawdown edge XLV −54.8% −37.9%
Risk-adjusted
Sharpe edge Tie 0.50 0.49
Sortino edge Tie 0.70 0.70
Calmar edge XLV 0.17 0.24
Reading

VTI returned more: +898.9% to +795.7%. XLV swung slightly less: 16.7% to 17.8%. XLV fell less at its worst: −37.9% to −54.8%.

Full scorecard

9 measures, with how each is measured
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Risk and return: VTI vs XLV: Differences, Returns & Fees
MeasureVTIXLVEdgeHow it is measured
Return
Total return+898.9%+795.7%VTIPrice change plus distributions, reinvested.
Annualized+9.5%+9.0%VTI (slight)Total return as a yearly rate.
Price return+540.9%+499.6%VTI (slight)Price change alone, distributions left out.
Risk
Volatility17.8%16.7%XLV (slight)Spread of weekly returns, annualized. Lower is steadier.
Downside deviation12.7%11.8%XLV (slight)Like volatility, counting only weeks below the Treasury bill rate.
Max drawdown−54.8%−37.9%XLVDeepest fall from a high to the low after it.
Risk-adjusted
Sharpe0.500.49TieReturn above Treasury bills per unit of volatility.
Sortino0.700.70TieReturn above Treasury bills per unit of downside deviation.
Calmar0.170.24XLVAnnualized return divided by the max drawdown.

Computed by ETFIQ from Tiingo daily prices and ETFIQ's distribution records, 1,324 weekly returns. Cash rate: the 13-week Treasury bill.

What they share

8%

By the books each fund has filed, VTI and XLV hold 8% of their money in the same securities at the same weight. Holdings dated Sep 30, 2026 and Oct 27, 2026.

0 half 100%

half

8% in common

Positions both hold · largest shared weight first VTI XLV
Eli Lilly & Co 1.34% 15.77%
Johnson & Johnson 0.87% 9.96%
AbbVie Inc 0.63% 7.78%
Merck & Co Inc 0.49% 5.38%
UnitedHealth Group Inc 0.45% 5.66%
Thermo Fisher Scientific Inc 0.34% 3.94%
Amgen Inc 0.31% 3.72%
Gilead Sciences Inc 0.25% 3.03%
Abbott Laboratories 0.23% 2.74%
Pfizer Inc 0.22% 2.61%
Intuitive Surgical Inc 0.20% 2.42%
Danaher Corp 0.19% 2.23%
Only in one fund ↓
Only in VTI
NVIDIA Corp 7.14%
Apple Inc 6.63%
Microsoft Corp 5.20%
Amazon.com Inc 3.30%
Alphabet Inc 2.76%
Broadcom Inc 2.28%
Meta Platforms Inc 2.18%
Alphabet Inc 2.18%
Only in XLV
XAV HEALTH CARE DEC26 0.01%
Check overlap with more funds →

Side by side

VTI Vanguard Morningstar Total Stock Market ETF XLV State Street Health Care Select Sector SPDR ETF
Where it sits Stock ETF Stock ETF
What it is Tracks an index of US total market Tracks an index of Health care
Total return, 1 year +13.5% +25.6%
Expense ratio 0.03% 0.08%
Already in the S&P 500 88.1% 99.7%
Holdings 3521 62
Net assets, VTI as of Sep 30, 2026 and XLV as of Oct 27, 2026 $689.2bn $47.0bn

VTI and XLV on the fields both publish, as of Oct 28, 2026. Source: ETFIQ.

Client brief · page 1 of 2 Report BR-C069888C8F

VTI and XLV do different jobs. What does each one do in a portfolio?

  1. What each follows. VTI follows Morningstar US Total Market Index and XLV follows Health Care Select Sector Index.
  2. Holdings in common. 8% of the weight is in the same securities (holdings dated Sep 30, 2026 and Oct 27, 2026).
  3. One-year total return. Over 1 year to Oct 28, 2026 VTI returned +13.5% and XLV +25.6% with distributions reinvested, a gap of 12.1 points.

Data as of Oct 28, 2026.

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About each fund
VTI

VTI tracks an index of US total market. Over the year to Oct 28, 2026 it returned +13.5% with distributions reinvested. The prospectus expense ratio is 0.03% a year. By its holdings published by its issuer as of Sep 30, 2026, 88% of the fund by weight is stocks the S&P 500 also holds, across 3,521 positions, with the top ten at 34.7%.

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, VTI or XLV?
In the year to Oct 28, 2026, with distributions reinvested, VTI returned +13.5% and XLV +25.6%.
Which is cheaper, VTI or XLV?
VTI 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.
How much do VTI and XLV overlap with the S&P 500?
By their latest filed holdings, 88% of VTI and 100% of XLV by weight is stocks the S&P 500 already holds.
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ETFIQ, VTI against XLV, data as of Oct 28, 2026. https://etfiq.com/compare/any/vti-vs-xlv

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