This paper presents a CMOS analog front-end for wearable A-mode ultrasound hand gesture recognition. This analog front-end is part of the research into using ultrasound to record and decode muscle signals with the aim of controlling a prosthetic hand as an alternative to surface electromyography. In this paper, the design of a pulser for driving piezoelectric transducers as well as a low-noise amplifier for the received echoes are presented. Simulation results show that the pulser circuit is capable of driving a 137 pF capacitive load with 30 V pulses at a frequency of 1 MHz and dissipates 142.1 mW power. The low-noise amplifier demonstrates a gain of 34 dB and an input-referred noise of 8.58 nV/v Hz at 1 MHz.