In this paper, we present an ultralow power heart rate (HR) monitoring photoplethysmography (PPG) sensor using a heartbeat locked loop (HBLL). The HBLL generates a narrow window that turns on the LED and analog-front-end only when a peak is expected in the PPG signal. The prototype PPG sensor implemented in 0.18 mu m CMOS has an effective duty-cycle of 0.01% and consumes only 43.4 mu W at a HR of 60 b/m, which is the lowest power consumption compared with previous state-of-the-art PPG sensors. The HR error of the proposed sensor is less than 2.1 b/m for HR below 180 b/m.