Open source
WinClicker
Every auto clicker I tried took over the cursor. WinClicker can post clicks to a window sitting behind others while you keep using the mouse and keyboard. It is a single 57 KB exe written in C#, with no installer.
57 KBsingle exe, no installer
3target modes
1 msminimum interval

How it works
- In window mode it finds the deepest child window under the point you pick and posts mouse messages to it, so the click lands without moving the cursor.
- Start and stop hotkeys come from a low-level keyboard hook that ignores auto-repeat.
- Clicking runs on its own thread against a stopwatch schedule that catches up instead of drifting.
- It builds with the C# compiler that ships with .NET Framework, so there is nothing extra to install to compile it.