This paper gives a systematic analysis of the effects of including an integrated (built-in) preamplifier into the ultrasonic piezoelectric probes (hydrophones) that are finding increasing use in biomedical applications. The design parameters considered include the end-of-cable sensitivity, gain, dynamic range, power supply requirements, construction intricacy, and cost. The rationale behind the inclusion of a preamplifier is given, and it is shown that the additional complexity introduced with the preamplifier into the measurement chain may not be warranted in all applications. Both the drawbacks and advantages of hydrophone preamplification are demonstrated, especially for the case of high pressure amplitude ultrasonic field measurements. Guidelines are developed for the potential user to identify the need for preamplification and the factors that influence the selection of the appropriate circuitry.