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Several Pinned Photodiode (PPD) CMOS Image Sensors (CIS) are designed, manufactured, characterized and exposed biased to ionizing radiation up to 10 kGy(SiO2 ). In addition to the usually reported dark current increase and quantum efficiency drop at short wavelengths, several original radiation effects are shown: an increase of the pinning voltage, a decrease of the buried photodiode full well capacity, a large change in charge transfer efficiency, the creation of a large number of Total Ionizing Dose (TID) induced Dark Current Random Telegraph Signal (DC-RTS) centers active in the photodiode (even when the Transfer Gate (TG) is accumulated) and the complete depletion of the Pre-Metal Dielectric (PMD) interface at the highest TID leading to a large dark current and the loss of control of the TG on the dark current. The proposed mechanisms at the origin of these degradations are discussed. It is also demonstrated that biasing (i.e., operating) the PPD CIS during irradiation does not enhance the degradations compared to sensors grounded during irradiation.