Photodetectors (PDs) are the building block of various imaging and sensing applications. However, commercially available PDs based on crystalline inorganic semiconductors cannot meet the requirements of emerging wearable/implantable applications due to their rigidity and fragility, which creates the need for flexible devices. Here, a high-performance flexible PD is presented by gating an organic electrochemical transistor (OECT) with a perovskite solar cell. Due to the ultrahigh transconductance of the OECT, the device demonstrates a high gain of ≈106 , a fast response time of 67 µs and an ultrahigh detectivity of 6.7 × 1017 Jones to light signals under a low working voltage (≤0.6 V). Thanks to the ultrahigh sensitivity and fast response, the device can track photoplethysmogram signals and peripheral oxygen saturation under ambient light and even provide contactless remote sensing, offering a low-power and convenient way for continuous vital signs monitoring. This work offers a novel strategy for realizing high-performance flexible PDs that are promising for low-power, user-friendly and wearable optoelectronics.