Whispering gallery mode (WGM) microcavities have been widely used for high-sensitivity ultrasound detection, owing to their optical and mechanical dual-resonance enhanced sensitivity. The ultrasound sensitivity of the cavity optomechanical system is fundamentally limited by thermal noise. In this work, we theoretically and experimentally investigate the thermal-noise-limited sensitivity of a WGM microdisk ultrasound sensor and optimize the sensitivity by varying the radius and a thickness of the microdisk, as well as using a trench structure around the disk. Utilizing a microdisk with a radius of 300 μm and thickness of 2 μm, we achieve a peak sensitivity of 1.18μPaHz-1/2 at 82.6 kHz. To the best of our knowledge, this represents the record sensitivity among cavity optomechanical ultrasound sensors. Such high sensitivity has the potential to improve the detection range of air-coupled ultrasound sensing technology.