An applicator for providing HIFU therapy to a patient includes a HIFU transducer that is rotatably coupled to a frame. In one embodiment, the rotatable coupling is configured such that the HIFU transducer can be mechanically oriented to position a focal zone of the HIFU transducer at any desired location in a treatment volume radially outward from a longitudinal axis of the applicator while the HIFU transducer remains within a housing that is not more than a defined percentage (e.g., 50%) larger than the maximum diameter of the HIFU transducer. In one embodiment, the HIFU transducer is rotatably coupled to the frame with a ball and socket joint. In another embodiment, the HIFU transducer is rotatably coupled to the frame with an offset gimble assembly. A pair of linear actuators and drive shafts engage the HIFU transducer to orient HIFU transducer in a desired direction.