This thesis reports for the first time the design, fabrication, and testing of a reusable Surface Acoustic Wave (SAW) sensor for biofilm growth monitoring. Bacterial biofilms cause severe infections, and are often difficult to remove without an invasive surgery. Thus, their detection at an early stage is critical for effective treatments. A highly sensitive SAW sensor for biofilm growth monitoring was fabricated by depositing a high quality zinc oxide (ZnO) piezoelectric thin film by pulsed laser deposition (PLD). The sensor was successfully passivated by aluminum oxide (Al2O3) using Atomic Layer Deposition (ALD) to prevent ZnO damage from long term media contact. The sensor was reusable over multiple biofilm formation experiments using the ALD Al2O3 passivation and an oxygen plasma biofilm cleaning method. The SAW sensor was studied with Escherichia coli biofilm growth in Lysogeny Broth (LB) and in 10% Fetal Bovine Serum (FBS) as a simulated an in vivo environment. A multiple MHz level resonant frequency shift measured at the output of the SAW sensor in both LB and 10% FBS corresponded to the natural biofilm growth progression. These repeatable E. coli biofilm growth monitoring results validate the novel application of a SAW sensor for future implantable biofilm sensing applications.