Coronary artery disease (CAD) is the third leading cause of disability and death globally. Intravascular ultrasound (IVUS) is the most commonly used imaging modality for the characterization of vulnerable plaques. The development of novel intravascular imaging and therapy devices requires dedicated open systems (e.g., for pulse sequences for imaging or thrombolysis), which are not currently available. This paper presents the development of a novel multifunctional FPGA-based pulser/receiver system for intravascular ultrasound imaging and therapy research. The open platform consists of a host PC with a Matlab-based software interface, an FPGA board, and a proprietary analog front-end board with state-of-the-art electronics for highly flexible transmission and reception schemes. The main features of the system include the capability to convert arbitrary waveforms into tristate bipolar pulses by using the PWM technique and by the direct acquisition of raw radiofrequency (RF) echo data. The results of a multicycle excitation pulse applied to a custom 550 kHz therapy transducer for acoustic characterization and a pulse-echo experiment conducted with a high-voltage, short-pulse excitation for a 19.48 MHz transducer are reported. Testing results show that the proposed system can be easily controlled to match the frequency and bandwidth required for different IVUS transducers across a broad class of applications.