Ultrasonic atomization is a critical process for producing micrometer-diameter droplets, widely utilized in aerosol drug delivery, spectrometry, and printing. The geometry of the vessel containing the fluid being atomized and the oscillations of its sidewalls play a crucial role in controlling the wave patterns and hence the droplet ejection process, especially at actuation frequencies exceeding 1 MHz. However, the mechanisms behind droplet ejection under high-frequency ultrasonic actuation remain poorly understood. We employ oscillating high-aspect-ratio Silicon microchannels to create ideal conditions where capillary forces, microchannel geometry, and oscillatory motion work together to precisely confine a liquid film and generate droplets with controlled diameters. We show that the three-dimensional vibrations of the microchannels, particularly the interplay between actuation frequency, amplitude, and channel geometry, can be used to effectively tune the ligament development and droplet breakup. This understanding allows us to establish conditions to reduce actuation power and hence minimize heating, control shear stresses and tune the droplet size on-demand without compromising uniformity and throughput.