This paper presents an ultrasound receiver ASIC in 180nm CMOS that enables element-level digitization of echo signals in miniature 3D ultrasound probes. It is the first to integrate an analog front-end and a 10-b Nyquist ADC within the 150 μ m element pitch of a 5-MHz 2D transducer array. To achieve this, a hybrid SAR/shared-single-slope architecture is proposed in which the ramp generator is shared within each 2 × 2 subarray. The ASIC consumes 1.54mW/element and has been successfully demonstrated in an acoustic imaging experiment.