An ultrasound device is describe in which analog ultrasonic transducer output signal are directly converted to digital signals. The ultrasound device includes microfabricated ultrasonic transducers directly coupled to a sigma delta analog-to-digital converter in some instances. The direct digital conversion may allow for omission of undesirable analog processing stages in the ultrasound circuitry chain. In some situations, the ADC may be integrated on the same substrate as the ultrasound transducer.