Indonesia’s healthcare sector continues to face challenges from regulatory reforms, changes in healthcare financing, and post-pandemic recovery. In response, mergers and acquisitions (M&A) have become an important strategy for hospital operators seeking to strengthen competitiveness and financial sustainability. This study comparatively examines the financial and stock performance of PT Sarana Meditama Metropolitan Tbk (SAME) across 16 quarters before (Q4 2017 - Q3 2021) and 16 quarters after (Q1 2022 - Q4 2025) its acquisition of PT Kedoya Adyaraya Tbk (RSGK) in 2021. Using a quantitative comparative and non-causal before-and-after design, the study evaluates profitability (ROA, ROE), liquidity (CR, QR), activity (TATO, FATO), solvency (DER, DAR), Market-Adjusted Return, and Stock Risk. Hypothesis testing is conducted using the Wilcoxon Signed-Rank Test and Paired-Samples t-test according to the normality of the paired differences, while the Brown–Forsythe test is applied to compare Stock Risk based on daily stock-return variability. The results show no statistically significant differences in ROA, ROE, CR, QR, TATO, FATO, and Market-Adjusted Return, indicating that profitability, liquidity, asset utilization, and market-relative return performance remained comparable across the two periods. In contrast, DER and DAR show statistically significant differences and lower values during the post-acquisition period, indicating lower leverage and a more conservative capital structure. Stock Risk also shows a statistically significant difference, with lower volatility during the post-acquisition period, indicating a more stable risk profile. Overall, the most evident differences between the pre- and post-acquisition periods were concentrated in SAME’s capital structure and stock risk rather than occurring uniformly across all dimensions of financial and stock performance.