A system and method for image reconstruction for non-contact ultrasound is provided, where maps or ultrasound images of a subject may be generated without physically contacting the subject. Adjusting or optimizing the photoacoustic excitation system may be performed, such as with beam shaping, surface modifications, or closed-loop automated adjustments. 2D and/or 3D spatial locations of source and receiver laser spots may be used to provide a spatial reference location for ultrasound image reconstruction in a clinically efficacious manner. In addition, point tracking, surface profile characterization, laser adjustments, and/or surface enhancements may be used to facilitate image reconstruction of the subject.