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This paper presents a tri-modal self-adaptive photoplethysmography (PPG) sensor interface IC for concurrently monitoring heart rate, SpO 2 , and pulse transit time, which is a critical intermediate parameter to derive blood pressure. By implementing a highly-reconfigurable analog front-end (AFE) architecture, flexible signal chain timing control, and flexible dual-LED drivers, this sensor interface provides wide operating space to support various PPG-sensing use cases. A heart-beat-locked-loop (HBLL) scheme is further extended to achieve time-multiplexed dual-input pulse transit time extraction based on two PPG sensors placed at fingertip and chest. A self-adaptive calibration scheme is proposed to automatically match the chip's operating point with the current use case, guaranteeing a sufficient signal-to-noise ratio for the user while consuming minimum system power. This paper proposes a DC offset cancellation (DCOC) approach comprised by a logarithmic transimpedance amplifier and an 8-bit SAR ADC, achieving a measured 38 nA residue error and 8.84 μA maximum input current. Fabricated in a 65nm CMOS process, the proposed tri-modal PPG sensor interface consumes 2.3-5.7 μW AFE power and 1.52 mm 2 die area with 102dB (SpO 2 mode), 110-116 dB (HR & PTT mode) dynamic range. A SpO 2 test case and a HR & PTT test case are both demonstrated in the paper, achieving 18.9 μW and 43.7 μW system power, respectively.