A one-time programmable (OTP) fuse includes a fuse link including a thin film resistor (TFR) layer between a first insulator layer and a second insulator layer. A first terminal of the OTP fuse includes a first conductive pillar through one of the first and second insulator layers and in contact with the TFR layer; and a second terminal of the OTP fuse includes a second conductive pillar through one of the first and second insulator layers and in contact with the TFR layer. The second conductive pillar and the TFR layer have a lateral contact interface having a same shape as an outer portion of the second conductive pillar. The second conductive pillar does not simply land on the TFR layer, but extends through it. Application of a current to the OTP fuse results in programming via rupture of the lateral contact interface (not electromigration in the fuse link).