A quadrature synthetic aperture front-end receiver for B-mode ultrasound imaging is presented. The receiver targets small-scale imaging applications such as capsule endoscopy and low-cost portable devices. System complexity, area, power consumption, and cost are minimized using synthetic aperture beamforming (SAB), whereby signals are processed in a sequential manner using only a single channel. SAB is combined with quadrature (I/Q) sampling, which further reduces the bandwidth and computational load. I/Q demodulation is carried out using a full custom analog front-end (AFE), which comprises a low-noise, variable gain preamplifier, followed by a passive mixer, programmable gain amplifier (PGA) and active lowpass filter. A novel preamplifier design is proposed, with quasi-exponential time-gain control and low noise (${\text{5.42 nV}}/\sqrt{\text{Hz}}$ input-referred noise). Overall, the AFE consumes ${\text{7.8 mW}}$ (static power) and occupies ${\text{1.5}}\,\text{mm}\times {\text{1.5}}\,\text{mm}$ in AMS ${\text{0.35}}\,\mu \text{m}$ CMOS. Real-time SAB is carried out using a Spartan-6 FPGA, which dynamically apodises and focuses the data by interpolating and applying complex phase rotations to the I/Q samples. For a frame rate of ${\text{7}}\,\text{Hz}$ , the power consumption is ${\text{3.4}}\,\text{mW}/\text{channel}$ across an aperture of 64 elements. B-mode images were obtained using a database of ultrasound signals ( ${\text{2.5}}\,\text{MHz}$ center frequency) derived from a commercial ultrasound machine. The normalized root mean squared error between the quadrature SAB image and the RF reference image was ${\text{13}}\%$. Image quality/frame rate may be tuned by varying the degree of spatial compounding.