We present a 16-channel readout integrated circuit (ROIC) with nanosecond-resolution time to digital converter (TDC) for pixelated Cadmium Telluride (CdTe) gamma-ray detectors. The 4 × 4 pixel array ROIC is the proof of concept of the 10 × 10 pixel array readout ASIC for positron-emission tomography (PET) scanner, positron-emission mammography (PEM) scanner, and Compton gamma camera. The electronics of each individual pixel integrates an analog front-end with switchable gain, an analog to digital converter (ADC), configuration registers, and a 4-state digital controller. For every detected photon, the pixel electronics provides the energy deposited in the detector with 10-bit resolution, and a fast trigger signal for time stamp. The ASIC contains the 16-pixel matrix electronics, a digital controller, five global voltage references, a TDC, a temperature sensor, and a band-gap based current reference. The ASIC has been fabricated with TSMC 0.25 m mixed-signal CMOS technology and occupies an area of 5.3 mm × 6.8 mm. The TDC shows a resolution of 95.5 ps, a precision of 600 ps at full width half maximum (FWHM), and a power consumption of 130W. In acquisition mode, the total power consumption of every pixel is 200 W. An equivalent noise charge (ENC) of 160 eRMS at maximum gain and negative polarity conditions has been measured at room temperature.