This paper presents the design of a lead zirconate titanate (PZT) diaphragm actuated by double-sided patterned electrodes. Au/Cr electrodes were deposited on bulk PZT wafers by sputtering while patterned by a lift-off process. SU-8 thick film was used to form the structural layer. Double-spiral electrode induced in-plane poling and piezoelectric elongation are converted to an out-of-plane displacement due to the confined boundary condition. The influence of different drive configurations and electrode parameters on deflection has been calculated by finite element methods (FEM) using a uniform field model. Impedance and quasi-static displacement spectra of the diaphragm were measured after poling. A double-sided patterned electrode diaphragm can be actuated by more drive configurations than a single-sided one. Compared with a single-sided electrode drive, a double-sided out-of-phase drive configuration increases the coupling coefficient of the fundamental resonance from 7.6% to 11.8%. The displacement response of the diaphragm increases from 2.6 to 8.6 nm V−1. Configurations including the electric field component perpendicular to the poling direction can stimulate shear modes of the diaphragm.