A fully hardware-based real-time digital wideband quadrature demodulation processor based on the Hilbert transform is proposed to process ultrasound radio frequency signals. The presented architecture combines 2 finite impulse response (FIR) filters to process in-phase and quadrature signals and includes a piecewise linear approximation architecture that performs the required square root operations. The proposed implementation enables flexibility to support different transducers with its ability to load on-the-fly different FIR filter coefficient sets. The complexity and accuracy of the demodulator processor are analyzed with simulated RF data; a normalized residual sum-of-squares cost function is used for comparison with the Matlab Hilbert function. Three implementations are integrated into a hand-held ultrasound system for experimental accuracy and performance evaluation. Real-time images were acquired from a reference phantom, demonstrating the feasibility of using the presented architecture to perform real-time digital quadrature demodulation of ultrasonic signal echoes. Experimental results show that the implementation, using only 2942 slices and 3 dedicated digital multipliers of a low-cost and low-power field-programmable gate array (FPGA) is accurate relative to a comparable software- based system; axial and lateral resolution of 1 mm and 2 mm, respectively, were obtained with a 12-mm piezoelectric transducer without postprocessing. Because the processing and sampling rates are the same, high-frequency ultrasound signals can be processed as well. For a 15-frame-per-second display, the hand-held ultrasonic imaging-processing core (FPGA, memory) requires only 45 mW (dynamic) when using a 5-MHz single-element piezoelectric transducer.