CSL Ltd (ASX: CSL) was once the ASX healthcare share many investors wished they had bought years earlier.
For a long time, it seemed almost unstoppable.
But the past few years have changed the story completely.
So, how have CSL shares actually performed over the last decade?
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The 10-year return
CSL shares are trading around $121.75.
Ten years ago, they were changing hands at around $119.00.
That means the share price has risen by approximately 2% over the decade.
That is a positive return, but it is much weaker than many investors would expect from a company that was once viewed as one of the highest-quality growth shares on the ASX.
Dividends have helped. CSL has paid 20 dividends over that period, totalling approximately $30.57 per share.
If those dividends are added to the share price gain, the total return becomes better. A shareholder who bought at $119 would have collected around $33.32 per share in combined capital gains and dividends, before tax and ignoring reinvestment.
That works out to a total return of roughly 28%.
What went wrong?
The frustrating part is that CSL shares were once much higher.
The stock traded around $315 in 2021, and was still around that level as recently as 2024.
At that point, long-term shareholders were sitting on a much stronger return. Since then, the decline has been painful.
I think the market has lost confidence in CSL's growth story.
The plasma business was disrupted by the pandemic, and higher collection and manufacturing costs made the recovery harder. The Vifor acquisition has also disappointed many investors, with questions about whether CSL paid too much and whether the asset can deliver the returns once hoped for.
The vaccine business has added another problem. Lower flu vaccination demand, particularly in the US, has placed pressure on CSL Seqirus and made earnings feel less predictable.
When a company trades on a premium valuation, investors expect reliable growth. CSL has not delivered enough of that in recent years, so the share price has been heavily punished.
Should you buy CSL shares for the next 10 years?
I would still say yes. CSL has clearly lost some of its shine, and investors should not assume the next decade will look like the company's best years.
But I think the sell-off has created a more attractive starting point.
The company still has global healthcare assets, deep scientific expertise, major plasma infrastructure, and exposure to medical needs that should remain important for many years.
I also think management has a chance to rebuild trust if earnings stabilise, costs improve, and the company proves that Vifor and Seqirus can become stronger contributors.
Foolish takeaway
CSL shares have delivered a modestly positive 10-year return, but the journey has been far from smooth.
The share price is only a fraction higher than it was a decade ago, although dividends lift the total return meaningfully.
The big lesson is that even outstanding companies can disappoint when expectations are too high.
For the next 10 years, I think CSL shares are worth buying on the belief that the business can recover, rebuild confidence, and deliver better growth than investors have seen recently.
