ITOT vs. XLV

Last updated Jun 9, 2026

ITOT (iShares Core S&P Total U.S. Stock Market ETF) and XLV (State Street Health Care Select Sector SPDR ETF) are both exchange-traded funds - ITOT is a Large Cap Blend Equities fund tracking the S&P Total Market Index, while XLV is a Health & Biotech Equities fund tracking the Health Care Select Sector Index. Both are passively managed. Over the past 10 years, ITOT returned 14.81%/yr vs 9.65%/yr for XLV. A 0.72 correlation means they provide meaningful diversification when combined. ITOT charges 0.03%/yr vs 0.08%/yr for XLV.

Performance

ITOT vs. XLV - Performance Comparison

The chart below illustrates the hypothetical performance of a $10,000 investment in iShares Core S&P Total U.S. Stock Market ETF (ITOT) and State Street Health Care Select Sector SPDR ETF (XLV). The values are adjusted to include any dividend payments, if applicable.

Returns By Period

In the year-to-date period, ITOT achieves a 9.09% return, which is significantly higher than XLV's -0.98% return. Over the past 10 years, ITOT has outperformed XLV with an annualized return of 14.81%, while XLV has yielded a comparatively lower 9.65% annualized return.

ITOT

• 1D: 0.31%
• 1M: 0.42%
• YTD: 9.09%
• 6M: 8.99%
• 1Y: 24.90%
• 3Y*: 21.07%
• 5Y*: 12.25%
• 10Y*: 14.81%

XLV

• 1D: -0.24%
• 1M: 6.38%
• YTD: -0.98%
• 6M: 1.65%
• 1Y: 15.62%
• 3Y*: 7.16%
• 5Y*: 6.05%
• 10Y*: 9.65%

*Multi-year figures are annualized to reflect compound growth (CAGR)

ITOT vs. XLV - Yearly Performance Comparison

	2026 (YTD)	2025	2024	2023	2022	2021	2020	2019	2018	2017
ITOT iShares Core S&P Total U.S. Stock Market ETF	9.09%	17.00%	23.80%	26.12%	-19.47%	25.68%	20.71%	30.67%	-5.33%	21.37%
XLV State Street Health Care Select Sector SPDR ETF	-0.98%	14.50%	2.47%	2.07%	-2.08%	26.04%	13.30%	20.45%	6.28%	21.77%

Correlation

The correlation between ITOT and XLV is 0.35, which is low. Their price movements are largely independent, making them effective diversification partners.

	Correlation
Correlation (1Y) Calculated over the trailing 1-year period	0.35
Correlation (3Y) Calculated over the trailing 3-year period	0.48
Correlation (5Y) Calculated over the trailing 5-year period	0.58
Correlation (10Y) Calculated over the trailing 10-year period	0.65
Correlation (All Time) Calculated using the full available price history since Jan 26, 2004	0.72

Over the past year, the correlation between ITOT and XLV has dropped to 0.35 - well below their long-term average of 0.72, suggesting their price drivers have been diverging.

ITOT vs. XLV - Sectors Allocation Comparison

Sectors	ITOT	XLV
Technology	33.8%	-
Financial Services	12.1%	-
Communication Services	10.3%	-
Consumer Cyclical	10.1%	-
Industrials	9.5%	-
Healthcare	9.0%	100.0%
Consumer Defensive	4.7%	-
Energy	3.7%	-
Real Estate	2.4%	-
Utilities	2.3%	-
Basic Materials	2.1%	-

Return for Risk

ITOT vs. XLV — Risk / Return Rank

Compare risk-adjusted metric ranks to identify better-performing investments over the past 12 months.

ITOT

ITOT Risk / Return Rank: 67
ITOT Sharpe Ratio Rank: 68
ITOT Sortino Ratio Rank: 66
ITOT Omega Ratio Rank: 67
ITOT Calmar Ratio Rank: 62
ITOT Martin Ratio Rank: 75

XLV

XLV Risk / Return Rank: 32
XLV Sharpe Ratio Rank: 32
XLV Sortino Ratio Rank: 34
XLV Omega Ratio Rank: 31
XLV Calmar Ratio Rank: 33
XLV Martin Ratio Rank: 28

The rank (0–100) shows how this investment's returns compare to the risk taken. Higher = better. Based on the past 12 months of data, combining Sharpe, Sortino, and other metrics used by quantitative funds and institutional investors.

ITOT vs. XLV - Risk-Adjusted Trends Comparison

This table presents a comparison of risk-adjusted performance metrics for iShares Core S&P Total U.S. Stock Market ETF (ITOT) and State Street Health Care Select Sector SPDR ETF (XLV). Risk-adjusted metrics are performance indicators that assess an investment's returns in relation to its risk, enabling a more accurate comparison of different investment options.

	ITOT	XLV	Difference
Sharpe ratio: Return per unit of total volatility	2.01	1.05	+0.96
Sortino ratio: Return per unit of downside risk	2.71	1.68	+1.04
Omega ratio: Gain probability vs. loss probability	1.36	1.19	+0.17
Calmar ratio: Return relative to maximum drawdown	2.81	1.50	+1.31
Martin ratio: Return relative to average drawdown	12.79	3.60	+9.19
Data is calculated on a 1-year rolling basis and updated daily. The trend shows the change in the indicator over the past month.

ITOT vs. XLV - Sharpe Ratio Comparison

The current ITOT Sharpe Ratio is 2.01, which is higher than the XLV Sharpe Ratio of 1.05. The chart below compares the historical Sharpe Ratios of ITOT and XLV, calculated using daily returns over the previous 12 months. A higher Sharpe Ratio indicates better risk-adjusted performance relative to the risk-free rate.

Sharpe Ratios by Period

	ITOT	XLV	Difference
Sharpe Ratio (1Y) Calculated over the trailing 1-year period	2.01	1.05	+0.96
Sharpe Ratio (5Y) Calculated over the trailing 5-year period	0.71	0.41	+0.30
Sharpe Ratio (10Y) Calculated over the trailing 10-year period	0.81	0.58	+0.23
Sharpe Ratio (All Time) Calculated using the full available price history	0.57	0.46	+0.10

Drawdowns

ITOT vs. XLV - Drawdown Comparison

The maximum ITOT drawdown since its inception was -55.20%, which is greater than XLV's maximum drawdown of -39.17%. Use the drawdown chart below to compare losses from any high point for ITOT and XLV.

Drawdown Indicators

	ITOT	XLV	Difference
Max Drawdown Largest peak-to-trough decline	-55.20%	-39.17%	-16.03%
Max Drawdown (1Y) Largest decline over 1 year	-8.90%	-10.47%	+1.57%
Max Drawdown (3Y) Largest decline over 3 years	-19.44%	-17.11%	-2.33%
Max Drawdown (5Y) Largest decline over 5 years	-25.36%	-17.11%	-8.25%
Max Drawdown (10Y) Largest decline over 10 years	-35.00%	-28.40%	-6.60%
Current Drawdown Current decline from peak	-2.65%	-4.32%	+1.67%
Average Drawdown Average peak-to-trough decline	-6.97%	-7.12%	+0.15%
Ulcer Index Depth and duration of drawdowns from previous peaks	1.95%	4.35%	-2.40%

Volatility

ITOT vs. XLV - Volatility Comparison

The current volatility for iShares Core S&P Total U.S. Stock Market ETF (ITOT) is 3.91%, while State Street Health Care Select Sector SPDR ETF (XLV) has a volatility of 5.02%. This indicates that ITOT experiences smaller price fluctuations and is considered to be less risky than XLV based on this measure. The chart below showcases a comparison of their rolling one-month volatility.

Volatility by Period

	ITOT	XLV	Difference
Volatility (1M) Calculated over the trailing 1-month period	3.91%	5.02%	-1.11%
Volatility (6M) Calculated over the trailing 6-month period	9.56%	10.66%	-1.10%
Volatility (1Y) Calculated over the trailing 1-year period	12.49%	14.99%	-2.50%
Volatility (5Y) Calculated over the trailing 5-year period, annualized	17.40%	14.76%	+2.64%
Volatility (10Y) Calculated over the trailing 10-year period, annualized	18.29%	16.58%	+1.71%

ITOT vs. XLV - Expense Ratio Comparison

ITOT has a 0.03% expense ratio, which is lower than XLV's 0.08% expense ratio. Despite the difference, both funds are considered low-cost compared to the broader market, where average expense ratios usually range from 0.3% to 0.9%.

Dividends

ITOT vs. XLV - Dividend Comparison

ITOT's dividend yield for the trailing twelve months is around 1.00%, less than XLV's 1.64% yield.

Position	TTM	2025	2024	2023	2022	2021	2020	2019	2018	2017	2016	2015
ITOT iShares Core S&P Total U.S. Stock Market ETF	1.00%	1.11%	1.23%	1.47%	1.66%	1.18%	1.41%	1.88%	2.14%	1.69%	1.83%	2.01%
XLV State Street Health Care Select Sector SPDR ETF	1.64%	1.60%	1.67%	1.59%	1.47%	1.33%	1.49%	2.17%	1.57%	1.47%	1.60%	1.43%

Frequently Asked Questions

Can I hold both ITOT and XLV in my portfolio?

ITOT and XLV have a correlation of 0.35, meaning they provide meaningful diversification benefit when combined. Depending on your allocation goals, holding both could reduce overall portfolio risk.

Which is riskier, ITOT or XLV?

XLV has higher volatility (5.02%) compared to ITOT (3.91%). In terms of maximum drawdown, ITOT dropped -55.20% vs XLV's -39.17%.

Which ETF is better, ITOT or XLV?

On 10-year performance, ITOT leads with 14.81% vs 9.65% for XLV. On fees, ITOT is cheaper at 0.03% per year. On volatility, ITOT has been the lower-risk option at 3.91%. The better choice depends on whether you care most about return, fees, risk, or income.

Which ETF has performed better, ITOT or XLV?

Over the 10-year period, ITOT has performed better with a 14.81% return vs 9.65%. Past performance does not guarantee future results, so compare this with risk, fees, and fund exposure.

Which ETF is cheaper, ITOT or XLV?

ITOT is cheaper with a 0.03% expense ratio, compared with 0.08% for XLV.

Which ETF pays a higher dividend yield, ITOT or XLV?

XLV has the higher dividend yield at 1.64%, compared with 1.00% for ITOT.

What is the main difference between ITOT and XLV?

ITOT is categorized as Large Cap Blend Equities, while XLV is Health & Biotech Equities. ITOT tracks S&P Total Market Index, while XLV tracks Health Care Select Sector Index. They also come from different issuers: iShares and State Street. Their fees differ too: 0.03% for ITOT and 0.08% for XLV.

Which has better risk-adjusted returns?

ITOT currently has the higher Sharpe Ratio (2.01 vs 1.05), meaning it's delivered slightly more return per unit of risk over the trailing 12 months. However, this ranking shifts over time - use the Risk/Return Score above for a more comprehensive view that combines Sharpe, Sortino, and other measures used by quantitative funds.