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The massive amounts of data generated by camera sensors motivate data processing inside pixel arrays, i.e., at the extreme-edge. Several critical developments have fueled recent interest in the processing-in-pixel-in-memory paradigm for a wide range of visual machine intelligence tasks, including (1) advances in 3D integration technology to enable complex processing inside each pixel in a 3D integrated manner while maintaining pixel density, (2) analog processing circuit techniques for massively parallel low-energy in-pixel computations, and (3) algorithmic techniques to mitigate non-idealities associated with analog processing through hardware-aware training schemes. This article presents a comprehensive technology-circuit-algorithm landscape that connects technology capabilities, circuit design strategies, and algorithmic optimizations to power, performance, area, bandwidth reduction, and application-level accuracy metrics. We present our results using a comprehensive co-design framework incorporating hardware and algorithmic optimizations for various complex real-life visual intelligence tasks mapped onto our P2M paradigm.