Abstract-This work presents a fully-programmable Internet of Things (IoT) visual sensing node that targets sub-mW power consumption in always-on monitoring scenarios. The system features a spatial-contrast 128x64 binary pixel imager with focalplane processing. The sensor, when working at its lowest power mode (10µW at 10 fps), provides as output the number of changed pixels. Based on this information, a dedicated camera interface, implemented on a low-power FPGA, wakes up an ultralow-power parallel processing unit to extract context-aware visual information. We evaluate the smart sensor on three alwayson visual triggering application scenarios. Triggering accuracy comparable to RGB image sensors is achieved at nominal lighting conditions, while consuming an average power between 193µW and 277µW , depending on context activity. The digital subsystem is extremely flexible, thanks to a fully-programmable digital signal processing engine, but still achieves 19x lower power consumption compared to MCU-based cameras with significantly lower on-board computing capabilities.