Background: Sensing of biomedical signals is crucial for monitoring of various health con-ditions. These signals have a very low amplitude (in µV) and a small frequency range (<500 Hz). In the presence of various common-mode interferences, biomedical signals are difficult to detect. Instrumentation amplifiers (INAs) are usually preferred to detect these signals due to their high common-mode rejection ratio (CMRR). Gain accuracy and CMRR are two important parameters associated with any INA. This article, therefore, focuses on the improvement of the gain accuracy and CMRR of a low power INA topology. Objective: The objective of this article is to achieve high gain accuracy and CMRR of low power INA by having high gain operational amplifiers (Op-Amps), which are the building blocks of the INAs. Methods: For the implementation of the Op-Amps and the INAs, the Cadence Virtuoso tool was used. All the designs and implementation were realized in 0.18 µm CMOS technology. Results: Three different Op-Amp topologies namely single-stage differential Op-Amp, folded cascode Op-Amp, and multi-stage Op-Amp were implemented. Using these Op-Amp topologies separately, three Op-Amp-based INAs were realized and compared. The INA designed using the high gain multi-stage Op-Amp topology of low-frequency gain of 123.89 dB achieves a CMRR of 164.1 dB, with the INA’s gain accuracy as good as 99%, which is the best when compared to the other two INAs realized using the other two Op-Amp topologies implemented. Conclusion: Using very high gain Op-Amps as the building blocks of the INA improves the gain accuracy of the INA and enhances the CMRR of the INA. The three Op-Amp-based INA designed with the multi-stage Op-Amps shows state-of-the-art characteristics as its gain accuracy is 99% and CMRR is as high as 164.1 dB. The power consumed by this INA is 29.25 µW by operating on a power supply of ±0.9V. This makes this INA highly suitable for low power measurement applications. © 2020 Bentham Science Publishers.