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This paper describes the design of CMOS receiver electronics for monolithic integration with capacitive micromachined ultrasonic transducer (CMUT) arrays for high-frequency intravascular ultrasound imaging. A custom 8-inch (20-cm) wafer is fabricated in a 0.35-μm two-poly, four-metal CMOS process and then CMUT arrays are built on top of the application specific integrated circuits (ASICs) on the wafer. We discuss advantages of the single-chip CMUT-on-CMOS approach in terms of receive sensitivity and SNR. Low-noise and high-gain design of a transimpedance amplifier (TIA) optimized for a forward-looking volumetric-imaging CMUT array element is discussed as a challenging design example. Amplifier gain, bandwidth, dynamic range, and power consumption trade-offs are discussed in detail. With minimized parasitics provided by the CMUT-on-CMOS approach, the optimized TIA design achieves a 90 fA/√Hz input-referred current noise, which is less than the thermal-mechanical noise of the CMUT element. We show successful system operation with a pulseecho measurement. Transducer-noise-dominated detection in immersion is also demonstrated through output noise spectrum measurement of the integrated system at different CMUT bias voltages. A noise figure of 1.8 dB is obtained in the designed CMUT bandwidth of 10 to 20 MHz.