We present both a theoretical and experimental demonstration of a fully differential variable gain am- plifier (VGA) with small total harmonic distortion (THD) for an electrocardiogram (ECG) acquisition system. Capacitive feedback technology is adopted to reduce the nonlinearity of VGA. The fully differential VGA has been fabricated in SMIC 0.18-μm CMOS process, and it only occupies 0.11 mm2. The measurements are in good agreement with simulation results. Experimental results show that the gain of VGA changes from 6.17 to 43.75 dB with a gain step of 3 dB. The high-pass comer frequency and low-pass comer frequency are around 0.22 Hz and 7.9 kHz, respectively. For each gain configuration, a maximal THD of 0.13% is obtained. The fully differential VGA has a low THD and its key performance parameters are well satisfied with the demands of ECG acquisition system application in the UWB wireless body area network.