Aiming at the fully differential (FD) sensing and high-precision small-signal output characteristics of micro-electromechanical systems (MEMS) gyroscopes, a low area overhead, high-gain, medium-speed, FD operation amplifier (Op-Amp) is designed for building a small-signal processing delta-Sigma analog-to-digital converter (ADC). The Op-Amp is a two-stage cascade structure, which combines folded cascade (FC) and gain-boosted technology to make the low frequency gain up to 129 dB, to meet the high-precision requirements of 18-bit delta-Sigma ADC. The first stage is FC gain-boosted structure, which uses a small bias current to achieve high-gain and low area overhead. In order to reduce the input noise, process smaller signals, the input pair adopts positive channel Metal–Oxide–Semiconductor (PMOS). The second-stage uses a large bias current to achieve a high unity gain bandwidth (UGB). Under the premise that the tail current source of the first stage is PMOS, in order to reduce the area overhead, abandoning the traditional common source (CS) structure of negative channel Metal–Oxide–Semiconductor (NMOS) input and PMOS as the current mirror load, adopting a new CS structure that PMOS input and NMOS used as independent bias current source. In this structure, the large overdrive voltage significantly reduces the size of transistors and greatly reduces the area overhead. The Op-Amp was implemented in SMIC 0.18 μm BCD process, 5 V supply voltage. Its post-layout simulation achieved a low-frequency gain of 129 dB, a UGB of 35 MHz and a phase margin (PM) of 62° for a load capacitance of 2 pF. Output voltage swings are ±3.71 V and including common mode feedback (CMFB), bias voltage generating circuit and filter capacitor, the area of Op-Amp is 167.162 μm × 200.82 μm. Behavioral-level verification shows that the designed Op-Amp meets the requirements of high-precision delta-Sigma ADCs.