2-D sparse arrays may push the development of low-cost 3-D systems, not needing to control thousands of elements by expensive application-specific integrated circuits (ASICs). However, there is still some concern about their suitability in applications, such as Doppler investigation, which inherently involve poor signal-to-noise ratios (SNRs). In this article, a novel real-time 3-D pulsed-wave (PW) Doppler system, based on a 256-element 2-D spiral array, is presented. Coded transmission (TX) and matched filtering were implemented to improve the system SNR. Standard sonograms as well as multigate spectral Doppler (MSD) profiles, along lines that can be arbitrarily located in different planes, are presented. The performance of the system was assessed quantitatively on experimental data obtained from a straight tube flow phantom. An SNR increase of 11.4 dB was measured by transmitting linear chirps instead of standard sinusoidal bursts. For a qualitative assessment of the system performance in more realistic conditions, an anthropomorphic phantom of the carotid arteries was used. Finally, real-time B-mode and MSD images were obtained from healthy volunteers.