Piezoelectric films have recently attracted considerable attention in the development of various sensor and actuator devices such as nonvolatile memories, tunable microwave circuits and ultrasound transducers. In this paper, an overview of the state of art in piezoelectric films for high frequency transducer applications is presented. Firstly, the basic principles of piezoelectric materials and design considerations for ultrasound transducers will be introduced. Following the review, the current status of the piezoelectric films and recent progress in the development of high frequency ultrasonic transducers will be discussed. Then details for preparation and structure of the materials derived from piezoelectric thick film technologies will be described. Both chemical and physical methods are included in the discussion, namely, the sol-gel approach, aerosol technology and hydrothermal method. The electric and piezoelectric properties of the piezoelectric films, which are very important for transducer applications, such as permittivity and electromechanical coupling factor, are also addressed. Finally, the recent developments in the high frequency transducers and arrays with piezoelectric ZnO and PZT thick film using MEMS technology are presented. In addition, current problems and further direction of the piezoelectric films for very high frequency ultrasound application (up to GHz) are also discussed. (C) 2010 Elsevier Ltd. All rights reserved.