A piezoelectric micromachined ultrasonic transducer comprising a substrate and a first dielectric film formed on the substrate. An opening having a sidewall is formed through the substrate and first dielectric film. A bottom electrode is formed on the first dielectric film spanning the opening. A piezoelectric element is formed on the bottom electrode. A second dielectric film surrounds the piezoelectric element. A conformal insulating film is formed on the sidewall of the opening. A conformal conductive film is formed in contact with the bottom electrode and on the sidewall of the opening, wherein an open cavity is maintained in the opening. A top electrode is formed in contact with the piezoelectric element.