A four-channel high-voltage transmitter chip for medical ultrasound imaging is reported. It uses a 9-level pulse-shaping technique to improve signal quality and reduce distortion, compared to both the traditional (linear) method and the multilevel solution with coarser discretization. The proposed architecture requires minimum off-chip components and it is scalable for more channels. Extensive chip-level simulations of the prototype chip response to different test signals are in progress. Simulation results demonstrate circuit performance and reveal full functionality of the system. As a significant example, the device response to a linear frequency modulated chirp pulse signal with 4 µs duration and amplitude tapering is here presented.