Medpace Holdings Inc. (MEDP) shares tumbled 5.60% in pre-market trading on Tuesday, following the release of its first-quarter 2025 financial results. Despite beating analyst expectations, the clinical research company's conservative full-year guidance and signs of slowing business momentum have raised concerns among investors.

The company reported impressive Q1 numbers, with revenue of $558.6 million surpassing analyst estimates of $527.2 million, and earnings per share (EPS) of $3.67 significantly beating the expected $3.06. However, Medpace's full-year 2025 outlook fell short of market expectations, projecting EPS between $12.26 and $13.04 and revenue between $2.14 billion and $2.24 billion, representing a modest growth of 1.5% to 6.2% over 2024.

Adding to investor concerns, Medpace reported a decrease in net new business awards, down 18.8% to $500.0 million, and a lower book-to-bill ratio of 0.90x. These factors suggest potential challenges in maintaining the company's growth trajectory, despite the strong quarterly performance. As a result, the market seems to be reevaluating Medpace's near-term prospects, leading to the significant pre-market sell-off.