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Focused ultrasound surgery (FUS) is usually based on frequencies below 5 MHz, typically around 1 MHz. Whilst this allows good penetration into tissue, it limits the minimum lesion dimensions that can be achieved. In the study reported here, we investigated devices to allow FUS at much higher frequencies, therefore in principle reducing the minimum lesion dimensions. We explain the methodology we have used to build high-frequency high-intensity transducers using Y-36° cut lithium niobate. This material was chosen as its low losses give it the potential to allow very high-frequency operation at harmonics of the fundamental operating frequency. A range of single element transducers with a centre frequency between 6.6 MHz and 20.0 MHz was built and the transducers' efficiency and acoustic power output were measured. A focussed 6.6-MHz transducer was built with multiple elements operated together and tested using an ultrasound phantom and MRI scans. It was shown to increase phantom temperature by 32°C in a localised area of 2.5 mm × 3.4 mm in the plane of the MRI scan. This study therefore demonstrates that it is feasible to produce high-frequency transducers capable of high-resolution focused ultrasound surgery using lithium niobate.