Catheters and methods for epicardial ablation are provided. A suitable catheter comprises an elongated catheter body and an ultrasound transducer mounted at or near the distal end of the catheter body. The transducer has a front surface and an opposing back surface, wherein the transducer is positioned to transmit ultrasound energy toward tissue facing the front surface but not toward tissue facing the back surface. A sensor is mounted within the catheter near the ultrasound transducer for sensing a location and an orientation of the ultrasound transducer within a patient. A suitable method involves introducing the distal end of the catheter introducing into the pericardium of a patient. The transducer's front surface is positioned so that it generally faces tissue to be ablated, and the tissue is ablated with ultrasound energy generated by the transducer.