A monolithic ultrasonic horn where the horn, backing, and pre-stress structures are combined in a single monolithic piece is disclosed. Pre-stress is applied by external flexure structures. The provision of the external flexures has numerous advantages including the elimination of the need for a pre-stress bolt. The removal of the pre-stress bolt eliminates potential internal electric discharge points in the actuator. In addition, it reduces the chances of mechanical failure in the actuator stacks that result from the free surface in the hole of conventional ring stacks. In addition, the removal of the stress bolt and the corresponding reduction in the overall number of parts reduces the overall complexity of the resulting ultrasonic horn actuator and simplifies the ease of the design, fabrication and integration of the actuator of the present invention into other structures.