This paper presents a novel piezoelectric micromachined ultrasonic transducer (PMUT) with theoretical simulation, fabrication, and testing. Conventional methods using a PCB or an external horn to adjust the PMUT acoustic field angle are limited by the need for transducer size. To address this limitation, the stepped-tube (expanded tube) backside cavity PMUT has been proposed. The stepped-tube PMUT and the tube PMUT devices have the same membrane structure, and the acoustic impedance matching of the PMUT is optimized by modifying the boundary conditions of the back cavity structure. The acoustic comparison experiments show that the average output sound pressure of the stepped-tube backside cavity PMUT has increased by 17%, the half-power-beam-width (θ-3db) has been reduced from 55° to 30° with a reduction of 45%, and the side lobe level signal is reduced from 147 mV to 66 mV. In addition, this work is fabricated on an eight-inch wafer. The process is compatible with standard complementary metal oxide semiconductor (CMOS), conditions are stable, and the cost is controllable, plus it facilitates the batch process. These conclusions suggest that the stepped-tube backside cavity PMUT will bring new, effective, and reliable solutions to ranging applications.