Are these the top 5 UK shares to buy in a Stocks and Shares ISA and hold forever?

Knowing which UK shares to buy in a Stocks and Shares ISA is the ultimate quest for investors. After all, buying bad stocks can easily destroy wealth, while owning the best ones can make someone an ISA millionaire.

So what are the best five stocks to buy right now? This is what the experts are recommending.

Five top UK picks from the pros

Like most investors, professional analysts from financial institutions are constantly searching for opportunities in the stock market to recommend to their clients.

Over the last few months, many have revealed their highest conviction UK stock picks for 2026 to buy and hold for the long run. And some recurring names appear when looking at the recommendations from institutions like UBS, Peel Hunt, AJ Bell, and others.

In order of market-cap, the list is:

• AstraZeneca (LSE:AZN).
• RELX.
• London Stock Exchange Group.
• 3i Group.
• Games Workshop.

So problem solved? Not quite. As talented as the experts are, they’re sadly not always right.

Shifts in the economic landscape, consumer preferences, regulatory shifts, and a plethora of other unforeseen forces can potentially derail even the most promising investment ideas.

That’s why investors must do a bit of digging to understand exactly what the opportunities are and the risks they face. With that in mind, let’s take a look at the largest stock on this list – AstraZeneca.

Risk versus reward

With a market-cap of £240bn, AstraZeneca’s one of the largest pharmaceutical giants in the world. Yet that doesn’t mean the growth story’s over.

In 2024, management laid out its ambition to grow revenue to $80bn by 2030. That’s 36% higher than the $58.7bn achieved in 2025. And with an impressive pipeline of new drugs in late-stage development, alongside an impressive compounding expansion of its oncology treatments, the company’s seemingly on track to hit this goal. It may even surpass it.

However, there are two prominent headwinds for investors to watch closely:

1. China.
2. Patent cliff concerns.

Last month, AstraZeneca’s former China head, Leon Wang, was formally charged with illegal trading, among other alleged crimes. And the company’s Chinese subsidiary has also been indicted.

China represented just over 10% of AstraZeneca’s revenue stream last year, and it serves as a critical expansion market for long-term growth. But if it loses this legal battle, AstraZeneca’s China expansion ambitions could be compromised.

Such an outcome is only made worse by the impending expiration of multiple blockbuster drug patents.

Management’s seeking to offset the anticipated incoming loss of future revenues by launching new treatments. But any delays in regulatory approval or late-stage clinical trial failures could similarly cause the firm to fall short of its $80bn revenue target.

What’s the verdict?

Even with the risks, there’s a lot to be bullish about when looking at AstraZeneca shares today. And the pharma giant definitely warrants a closer inspection from investors looking for quality long-term stock picks to add to their Stocks and Shares ISA.

The same is true for the other companies on this list. But just like AstraZeneca, they also have their own skeletons in the closet that could lead to disappointing results. Only by understanding both the risk and potential reward can investors hope to build sustainable wealth in the stock market.

The post Are these the top 5 UK shares to buy in a Stocks and Shares ISA and hold forever? appeared first on The Motley Fool UK.

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Zaven Boyrazian has positions in Games Workshop Group Plc. The Motley Fool UK has recommended AstraZeneca Plc, Games Workshop Group Plc, London Stock Exchange Group Plc, and RELX. Views expressed on the companies mentioned in this article are those of the writer and therefore may differ from the official recommendations we make in our subscription services such as Share Advisor, Hidden Winners and Pro. Here at The Motley Fool we believe that considering a diverse range of insights makes us better investors.

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