This paper investigates the feasibility of conformal heating for external ultrasound hyperthermia by using a phased array transducer with mechanical motion. In this system, a one-dimensional phased array is arranged on a shaft and moves along the shaft, while dynamically focusing on the planning target volume (PTV) with numerous focal spots. To prevent overheating in the intervening tissue between the skin and the PTV, the shaft and the phased array are rotated together to enlarge the acoustical window. With the purpose of conformal heating, the power deposition of the PTV is constructed by combinations of the focal spots and an iterative gradient descent method is then used to determine an optimal set of power weightings for the focal spots. Different tumour shapes are evaluated and the simulation results demonstrate that the volume percentage of the PTV with temperatures higher than 43 °C is over 95%. The overheating volume outside the PTV is less than 25% of the PTV. This method provides good conformal heating for external ultrasound hyperthermia. The concept of combining electrical focusing and mechanical motion has the advantages of both enlarging the acoustic window and providing dynamic focusing ability, which is essential for successful conformal heating.