This paper presents the design and development of a high-resolution 3D ultrasound imaging system based on a 1 × 256 piezoelectric ring array, achieving an accuracy of 0.1 mm in both ascending and descending modes. The system achieves an imaging spatial resolution of approximately 0.78 mm. A 256 × 32 cylindrical sensor array and a digital phantom of breast tissue were constructed using the k-Wave toolbox. The signal is acquired layer by layer using 3D acoustic time-domain simulation, resulting in the collection of data from each of the 32 layers. The 1 × 256 ring array moves on a vertical trajectory from the chest wall to the nipple at a constant speed. A data set was collected at intervals of 1.5 mm, resulting in a total of 32 data sets. Surface rendering and volume rendering algorithms were used to reconstruct 3D ultrasound images from the volume data obtained via simulation so that the smallest simulated reconstructed lesion had a diameter of 0.3 mm. The reconstructed three-dimensional image derived from the experimental data exhibits the contour of the breast model along with its internal mass. Reconstructable dimensions can be achieved up to approximately 0.78 mm. The feasibility of applying the system to 3D breast ultrasound imaging has been demonstrated, demonstrating its attributes of resolution, precision, and exceptional efficiency.