An inhomogeneous wave equation is derived describing propagation and scattering of ultrasound in an inhomogeneous medium. The scattering term is a function of density and propagation velocity perturbations. The integral solution to the wave equation is combined with a general description of the field from typical transducers used in clinical ultrasound to yield a model for the received pulse-echo pressure field. Analytic expressions are found in the literature for a number of transducers, and any transducer excitation can be incorporated into the model. An example is given for a concave, nonapodized transducer in which the predicted pressure field is compared to a measured field.