The performance of inductors at high frequencies and small sizes is one of the largest limiting factors in the continued miniaturization of dc-dc converters. Piezoelectric resonators can have a very high quality factor and provide an inductive impedance between their series and parallel resonant frequencies, making them a promising technology for further miniaturizing dc-dc converters. In this paper we analyze the impact of resonator parameters on the performance of the piezoelectric resonator based dc-dc converter, derive the optimal load impedance and efficiency limits, and analyze the impacts of varying conversion ratio and load impedance. This work is accompanied by a prototype dc-dc converter using a piezoelectric resonator fabricated from lithium niobate. The piezoelectric resonator has a quality factor of 4178 and a coupling coefficient, k 2 t , of 29%. The converter is able to achieve high efficiency zero voltage switching and a continuously variable conversion ratio without the use of any discrete inductors. It achieves a maximum power output of 30.9 W at an efficiency of 95.2% with a power density of 6.76 W cm 3 .