The application requirements of high frame rate CMOS image sensors (CIS) in the industry have not been satisfied due to the speed limitations in traditional single-slope and serial two-step analog-to-digital converters (ADCs). In this paper, a high-speed fully differential two-step ADC design method for CIS was proposed. The proposed method was based on differential ramp and time-to-digital conversion (TDC) technology. A parallel conversion mode was formed that is different from serial conversion, and the robustness of the system was ensured due to the existence of differential ramps. Aiming at the inconsistency between traditional TDC technology and single-slope ADC, a TDC technology based on level coding was proposed. The proposed technology achieves the TDC in the last clock cycle of analog-to-digital conversion, and realized a two-step conversion process at another level. This paper presents a complete circuit design, layout design, and test verification of the proposed design method based on the 55 nm 1P4M CMOS experimental platform. Under the design environment of the analog voltage of 3.3 V, the digital voltage of 1.2 V, the clock frequency of 100 MHz, and a dynamic input range of 1.6 V, this design was a 12-bit ADC with a conversion time of 480 ns, column-level power consumption of 62 μW, differential nonlinearity (DNL) of +0.6/−0.6 LSB, and integral nonlinearity (INL) of +1.2/−1.4 LSB. Furthermore, it achieved a signal-to-noise distortion ratio (SNDR) of 70.08 dB. The proposed design provided a large area array with a high frame rate, and compared with the existing advanced single-slope ADC, its conversion speed increased by more than 52%. It provides an effective solution for the implementation of high frame frequency CIS.