The clinical utility of pulse-echo ultrasound images is severely limited by inherent poor resolution that impacts negatively on their diagnostic potential. Research into the enhancement of image quality has mostly been concentrated in the areas of blind image restoration and speckle removal, with little regard for accurate modeling of the underlying tissue reflectivity that is imaged. The acoustic response of soft biological tissues has statistics that differ substantially from the natural images considered in mainstream image processing: although, on a macroscopic scale, the overall tissue echogenicity does behave somewhat like a natural image and varies piecewise-smoothly, on a microscopic scale, the tissue reflectivity exhibits a pseudo-random texture (manifested in the amplitude image as speckle) due to the dense concentrations of small, weakly scattering particles. Recognizing that this pseudo-random texture is diagnostically important for tissue identification, we propose modeling tissue reflectivity as the product of a piecewise-smooth echogenicity map and a field of uncorrelated, identically distributed random variables. We demonstrate how this model of tissue reflectivity can be exploited in an expectation-maximization (EM) algorithm that simultaneously solves the image restoration problem and the speckle removal problem by iteratively alternating between Wiener filtering (to solve for the tissue reflectivity) and wavelet-based denoising (to solve for the echogenicity map). Our simulation and in vitro results indicate that our EM algorithm is capable of producing restored images that have better image quality and greater fidelity to the true tissue reflectivity than other restoration techniques based on simpler regularizing constraints.