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Our list of the largest German hospital operators provides you with comprehensive insights into the highest-revenue hospital groups and clinics. In addition to current revenue and employee figures, you will also find valuable information on industry focus, managing directors, and contact details. The data is conveniently available as an Excel file for direct download.
Summary
Short answer: The largest hospital operator in Germany, based on the exclusive Researchgermany list of the largest hospital operators in Germany, is Fresenius SE & Co. KGaA. According to the Fresenius Annual Report 2023, the group generated revenues of €22.3 billion. This clearly puts Fresenius ahead of Asklepios Kliniken (€5.5 billion), Sana Kliniken (€3.3 billion), Alexianer (tba, 2022: €1.8 billion) and Agaplesion (€1.8 billion).
Comparison of the largest hospital operators in Germany (Revenue 2023)
The following presents the largest German hospital operators based on the Researchgermany list:
| Ranking | Company | Legal form | Revenue 2023 (m €) | Employees 2023 | Headquarters | Website |
|---|---|---|---|---|---|---|
| 1 | Fresenius SE & Co. KGaA | SE & Co. KGaA | 22,299 | 191,729 | Bad Homburg | fresenius.de |
| 2 | Asklepios Kliniken GmbH & Co. KGaA | GmbH & Co. KGaA | 5,452 | 49,425 | Hamburg | asklepios.com |
| 3 | Sana Kliniken AG | AG | 3,297 | 31,489 | Ismaning | sana.de |
| 4 | Alexianer GmbH | GmbH | tba (2022: 1,829) | 32,043 | Münster | alexianer.de |
| 5 | AGAPLESION gAG | gAG | 1,805 | 19,913 | Frankfurt am Main | agaplesion.de |
Why Fresenius is the largest hospital operator
- Revenue scale: In 2023, Fresenius generated revenues of €22.3 billion. This exceeds Asklepios’s revenue (€5.5 billion) by more than four times and underscores its dominant market position (Fresenius Annual Report 2023, pp. 5–8).
- Helios segment: The Helios division comprises more than 130 hospitals and around 100 medical care centers in Germany and Spain. With revenues of around €11.4 billion, Helios is Europe’s largest private hospital operator (see 2023 report, segment section pp. 112 ff.).
- Broad setup: In addition to Helios, Fresenius operates further strong segments with Kabi (pharmaceuticals & infusions), Vamed (hospital projects) and Medical Care (dialysis) that support the business.
- Workforce strength: With 191,729 employees, Fresenius is one of Germany’s largest employers, significantly larger than Asklepios (49,425) or Sana (31,489).
Competitor assessment
Asklepios is the second-largest private hospital group in Germany after Fresenius and achieved revenues of €5.5 billion in 2023. Sana follows with €3.3 billion. Alexianer and Agaplesion are important operators with a broad network of facilities but play in a smaller revenue league. In comparison, it becomes clear that Fresenius/Helios dominates the German market.
Source
- Fresenius Annual Report 2023 (information on revenue, Helios segment, employee figures).
- Researchgermany ranking of the largest hospital operators 2025
Image source: Getty Images, 09.09.2025
Last Updated on 4 months ago
