Due to its strong piezoelectric effect and photo-elastic property, lithium niobate is widely used for acousto-optical applications. However, conventional bulk lithium niobate waveguide devices exhibit a large footprint and limited light–sound interaction resulting from the weak guiding of light. Here, we report the first acousto-optical modulators with surface acoustic wave generation, phononic cavity, and low-loss photonic waveguide devices monolithically integrated on a 500 nm thick film of lithium niobate on an insulator. Modulation efficiency was optimized by properly arranging the propagation directions of surface acoustic waves and optical guided modes. The effective photo-elastic coefficient extracted by comparing the first and third harmonic modulation signals from an on-chip Mach–Zehnder interferometer indicates the excellent acousto-optical properties of lithium niobate are preserved in the thin film implementation. Such material property finding is of crucial importance in designing various types of acousto-optical devices. Much stronger amplitude modulation was achieved in a high Q (>300,000) optical resonator due to the higher optical sensitivity. Our results pave the path for developing novel acousto-optical devices using thin film lithium niobate.