Ultrasoundâpowered implants (UPIs) represent cutting edge power sources for implantable medical devices (IMDs), as their powering strategy allows for extended functional lifetime, decreased size, increased implant depth, and improved biocompatibility. IMDs are limited by their reliance on batteries. While batteries proved a stable power supply, batteries feature relatively large sizes, limited life spans, and toxic material compositions. Accordingly, energy harvesting and wireless power transfer (WPT) strategies are attracting increasing attention by researchers as alternative reliable power sources. Piezoelectric energy scavenging has shown promise for low power applications. However, energy scavenging devices need be located near sources of movement, and the power stream may suffer from occasional interruptions. WPT overcomes such challenges by more stable, onâdemand power to IMDs. Among the various forms of WPT, ultrasound powering offers distinct advantages such as low tissueâmediated attenuation, a higher approved safe dose (720Â mWÂ cmâ2), and improved efficiency at smaller device sizes. This study presents and discusses the stateâofâtheâart in UPIs by reviewing piezoelectric materials and harvesting devices including leadâbased inorganic, leadâfree inorganic, and organic polymers. A comparative discussion is also presented of the functional material properties, architecture, and performance metrics, together with an overview of the applications where UPIs are being deployed.