Piezoelectric micromachined ultrasound transducers (pMUTs) are a new approach for the construction of 2-D arrays for forward-looking 3-D intravascular (IVUS) and intracardiac (ICE) imaging. Two-dimensional pMUT test arrays containing 25 elements (5 x 5 arrays) were bulk micromachined in silicon substrates. The devices consisted of lead zirconate titanate (PZT) thin film membranes formed by deep reactive ion etching of the silicon substrate. Element widths ranged from 50 to 200 microm with pitch from 100 to 300 mum. Acoustic transmit properties were measured in de-ionized water with a calibrated hydrophone placed at a range of 20 mm. Measured transmit frequencies for the pMUT elements ranged from 4 to 13 MHz, and mode of vibration differed for the various element sizes. Element capacitance varied from 30 to over 400 pF depending on element size and PZT thickness. Smaller element sizes generally produced higher acoustic transmit output as well as higher frequency than larger elements. Thicker PZT layers also produced higher transmit output per unit electric field applied. Due to flexure mode operation above the PZT coercive voltage, transmit output increased nonlinearly with increased drive voltage. The pMUT arrays were attached directly to the Duke University T5 Phased Array Scanner to produce real-time pulse-echo B-mode images with the 2-D pMUT arrays.