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The development of a field-programmable gate array (FPGA)-based pulsed-wave Doppler processing approach in pure digital domain is reported in this paper. After the ultrasound signals are digitized, directional Doppler frequency shifts are obtained with a digital-down converter followed by a low-pass filter. A Doppler spectrum is then calculated using the complex fast Fourier transform core inside the FPGA. In this approach, a pulsed-wave Doppler implementation core with reconfigurable and real-time processing capability is achieved.