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    <filerInfo>
      <filer>
        <filerCredentials>
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      <liveTestFlag>LIVE</liveTestFlag>


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      <issuerCik>0001035267</issuerCik>
      <issuerName>INTUITIVE SURGICAL INC</issuerName>
      <secFileNumber>000-30713</secFileNumber>
      <issuerAddress>
        <com:street1>1020 KIFER ROAD</com:street1>
        <com:city>SUNNYVALE</com:city>
        <com:stateOrCountry>CA</com:stateOrCountry>
        <com:zipCode>94086</com:zipCode>
      </issuerAddress>
      <issuerContactPhone>4085232100</issuerContactPhone>
      <nameOfPersonForWhoseAccountTheSecuritiesAreToBeSold>GUTHART GARY S</nameOfPersonForWhoseAccountTheSecuritiesAreToBeSold>
      <relationshipsToIssuer>
        <relationshipToIssuer>Officer</relationshipToIssuer>
        <relationshipToIssuer>Director</relationshipToIssuer>
      </relationshipsToIssuer>
    </issuerInfo>
    <securitiesInformation>
      <securitiesClassTitle>COMMON</securitiesClassTitle>
      <brokerOrMarketmakerDetails>
        <name>THE CHARLES SCHWAB CORPORATION</name>
        <address>
          <com:street1>3000 Schwab Way</com:street1>
          <com:city>Westlake</com:city>
          <com:stateOrCountry>TX</com:stateOrCountry>
          <com:zipCode>76262</com:zipCode>
        </address>
      </brokerOrMarketmakerDetails>
      <noOfUnitsSold>7440</noOfUnitsSold>
      <aggregateMarketValue>3841346.00</aggregateMarketValue>
      <noOfUnitsOutstanding>356179445</noOfUnitsOutstanding>
      <approxSaleDate>10/30/2024</approxSaleDate>
      <securitiesExchangeName>NASDAQ</securitiesExchangeName>
    </securitiesInformation>
    <securitiesToBeSold>
      <securitiesClassTitle>COMMON</securitiesClassTitle>
      <acquiredDate>02/04/2019</acquiredDate>
      <natureOfAcquisitionTransaction>STOCK OPTION EXERCISE</natureOfAcquisitionTransaction>
      <nameOfPersonfromWhomAcquired>ISSUER</nameOfPersonfromWhomAcquired>
      <isGiftTransaction>N</isGiftTransaction>
      <amountOfSecuritiesAcquired>7440</amountOfSecuritiesAcquired>
      <paymentDate>02/04/2019</paymentDate>
      <natureOfPayment>NA</natureOfPayment>
    </securitiesToBeSold>
    <nothingToReportFlagOnSecuritiesSoldInPast3Months>Y</nothingToReportFlagOnSecuritiesSoldInPast3Months>
    <remarks>Full account titles, 3720 shares sold by JOSEPH CLAY GUTHART 2020 IRREVOCABLE TRUST G GUTHART &amp; D GUTHART TTEE 3720 shares sold by MIA HANNAH GUTHART 2020 IRREVOCABLE TRUST G GUTHART &amp; D GUTHART TTEE</remarks>
    <noticeSignature>
      <noticeDate>10/30/2024</noticeDate>
      <planAdoptionDates>
        <planAdoptionDate>04/30/2024</planAdoptionDate>
      </planAdoptionDates>
      <signature>GARY GUTHART</signature>
    </noticeSignature>
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144
0001280628
XXXXXXXX
LIVE
0001035267
INTUITIVE SURGICAL INC
000-30713
1020 KIFER ROAD
SUNNYVALE
CA
94086
4085232100
GUTHART GARY S
Officer
Director
COMMON
THE CHARLES SCHWAB CORPORATION
3000 Schwab Way
Westlake
TX
76262
7440
3841346.00
356179445
10/30/2024
NASDAQ
COMMON
02/04/2019
STOCK OPTION EXERCISE
ISSUER
N
7440
02/04/2019
NA
Y
Full account titles, 3720 shares sold by JOSEPH CLAY GUTHART 2020 IRREVOCABLE TRUST G GUTHART & D GUTHART TTEE 3720 shares sold by MIA HANNAH GUTHART 2020 IRREVOCABLE TRUST G GUTHART & D GUTHART TTEE
10/30/2024
04/30/2024
GARY GUTHART