Equivalent circuits for piezoelectric devices and ultrasonic transmission media can be used to cosimulate electronics and ultrasound parts in simulators originally intended for electronics. To achieve efficient system-level optimization, it is important to simulate correct, absolute amplitude of the ultrasound signal in the system, as this determines the requirements on the electronics regarding dynamic range, circuit noise, and power consumption. This paper presents methods to achieve correct, absolute amplitude of an ultrasound signal in a simulation of a pulse-echo system using equivalent circuits. This is achieved by taking into consideration loss due to diffraction and the effect of the cable that connects the electronics and the piezoelectric transducer. The conductive loss in the transmission line that models the propagation media of the ultrasound pulse is used to model the loss due to diffraction. Results show that the simulated amplitude of the echo follows measured values well in both near and far fields, with an offset of about 10%. The use of a coaxial cable introduces inductance and capacitance that affect the amplitude of a received echo. Amplitude variations of 60% were observed when the cable length was varied between 0.07 m and 2.3 m, with simulations predicting similar variations. The high precision in the achieved results show that electronic design and system optimization can rely on system simulations alone. This will simplify the development of integrated electronics aimed at ultrasound systems.