Current HIFU challenges include amount of tissue that can be destroyed by a single exposure, the inability to treat through bone, difficulty in monitoring therapy in real‐time, and difficulty in planning the strategy before therapy. Technological advances such as multi‐transducer or array beam generator, instrumentation and image‐based guidance of HIFU treatment promise to overcome many of these problems. However, there is limited work toward HIFU dosimetry and therapy planning. We present a systematic approach for developing pre‐treatment planning and HIFU dose calculations for specific target location using simulations and imaging data. We also present initial techniques and tools towards HIFU treatment planning (targeted for open‐skull brain tumor therapy) using patient‐specific pre‐therapy imaging (e.g., CT or MRI) similar to dosimetry and planning for radiation therapy. This work has potential to aid development of optimized high‐precision HIFU dosimetry and patient‐specific planning strategies for complex and sensitive applications such as in brain tumor HIFU therapy. If successful, it potentially could reduce the guess work on dosage parameters and thereby reducing the overall treatment duration and reduced exposure to non‐target tissues.