The acoustic power of high-intensity focused ultrasound (HIFU) is an important parameter that should be measured prior to each treatment to guarantee effective and safe outcomes. A new calibration technique was developed that involves estimating the pressure distribution, calculating the acoustic power using an underwater pressure blast sensor, and compensating the contribution of harmonics to the acoustic power. The output of a clinical extracorporeal HIFU system (center frequency of ~1 MHz, p+ = 2.5–57.2 MPa, p− = −1.8 to −13.9 MPa, ISPPA = 513–22,940 W/cm2, −6 dB size of 1.6 × 10 mm: lateral × axial) was measured using this approach and then compared with that obtained using a radiation force balance. Similarities were found between each method at acoustic power ranging from 18.2 W to 912 W with an electrical-to-acoustic conversion efficiency of ~42%. The proposed method has advantages of low weight, smaller size, high sensitivity, quick response, high signal-to-noise ratio (especially at low power output), robust performance, and easy operation of HIFU exposimetry measurement.