A nickel silicide polysilicon eFUSE provides a reliable, highly resistive programmed fuse while enabling reconfiguration of the VLSI functional features in traditional eFUSE applications with zero addition to the manufacturing process. The eFUSE has a history of wide use in embedded systems [1,2]. In previous work, a 65nm macro employed an array structure which improved areaper- bit by >10× and reduced programming time by >90% [3] over the traditional design [4]. For 45nm and beyond, it is necessary to have a design that has a Vt-mismatch-immune sense scheme, provides a sufficient voltage window for field- ogramming, and has in-hardware testability features for commercial design. This paper describes a second-generation one-time programmable read-only memory (OTPROM) that provides these features through a balanced bitline, resistor pull-up, differential sense amp with a programmable reference.