Bitcoin (CRYPTO: BTC) fell 23.8% in Q1 2026, the worst first-quarter performance since 2018, despite U.S. spot Bitcoin ETFs recording $1.32 billion in net inflows during March after four consecutive months of outflows.

The Six-Month Slide

Bitcoin closed Q1 at $66,619 on Tuesday, down from $87,508 on January 1. 

The quarterly drop represents the largest since Q1 2018, when Bitcoin fell 50% from $14,112 to $6,973.

The decline extends the 23% drop in Q4 2025, when Bitcoin slipped to $87,508 from $114,057. 

Andri Fauzan Adziima, Research Lead at Bitrue, said Bitcoin’s first-quarter decline stemmed primarily from ETF outflows, coupled with sticky inflation, a cautious Fed, and broader risk-off sentiment across markets. 

According to SoSoValue data, spot Bitcoin ETFs saw $496.5 million in net outflows during Q1, with $1.8 billion in outflows during January and February partially offset by $1.32 billion in March inflows.

The March Reversal

March marked Bitcoin’s first positive monthly candle in six months and first monthly ETF inflows since October, suggesting a potential shift in momentum. 

This follows four consecutive months of net outflows: $3.5 billion in November, $1.1 billion in December, $1.6 billion in January, and $206 million in February.

However, ETF investors remain underwater on average, with an estimated cost basis near $84,000 compared to current prices around $68,000.

April’s Historical Edge

April has historically been one of Bitcoin’s strongest months, with positive returns in 7 of the last 10 years. The market often refers to it as “Uptober’s cousin.”

Bitcoin is up 0.44%, trapped inside a rising wedge between the lower trendline around $67,000 and Supertrend resistance at $74,099. 

The 20 EMA at $68,825 sits right on top of price—a level Bitcoin needs to clear convincingly to build any bullish momentum.

All higher EMAs—50 at $70,965, 100 at $76,579, 200 at $84,943—remain well above, forming a heavy ceiling. 

Given current macro pressure and the wedge structure, April needs a clean break above $74,100 to follow the historical script. Otherwise, the pattern breaks down toward $62,000-$64,000.

What Q2 Needs

“Reversing the trend in Q2 will require renewed ETF inflows, clearer progress on crypto-friendly U.S. regulations, and a shift toward easier monetary conditions,” said Nick Ruck, LVRG Research Director.

Min Jung, research associate at Presto Research, noted that long-term conviction in Bitcoin remains intact. “There is limited evidence of a structural shift in long-term conviction around Bitcoin. Institutional participation and adoption trends remain intact, suggesting the move has been more cyclical than fundamental.”

Additionally, President Trump announced the U.S.-Iran conflict could end in two to three weeks, even without a deal, potentially providing the macro clarity analysts say is necessary for a Q2 reversal.

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