© 2020, The Author(s). Hybrid acoustic-RF systems offer excellent ranging accuracy, yet they typically come at a power consumption that is too high to meet the energy constraints of mobile IoT nodes. We combine pulse compression and synchronized wake-ups to achieve a ranging solution that limits the active time of the nodes to 1 ms. Hence, an ultra low-power consumption of 9.015 µW for a single measurement is achieved. The operation time is estimated on 8.5 years on a CR2032 coin cell battery at a 1 Hz update rate, which is over 250 times larger than state-of-the-art RF-based positioning systems. Measurements based on a proof-of-concept hardware platform show median distance error values below 10 cm. Both simulations and measurements demonstrate that the accuracy is reduced at low signal-to-noise ratios and when reflections occur. We introduce three methods that enhance the distance measurements at a low extra processing power cost. Hence, we validate in realistic environments that the centimeter accuracy can be obtained within the energy budget of mobile devices and IoT nodes. The proposed hybrid signal ranging system can be extended to perform accurate, low-power indoor positioning.