This review paper provides an extensive overview of elastic conductive fibers (ECFs), highlighting their evolution, design, and applications in stretchable electronics. ECFs are versatile due to their superior mechanical properties, lightweight nature, and ease of integration, making them ideal for wearable technology, health monitoring, aerospace, and bioengineering. The paper examines how ECFs combine fiber flexibility with electronic functionality, maintaining conductivity under mechanical deformation, and explores their use in wearable electronics, soft robotics, bioelectronics, and flexible energy devices. Key challenges discussed include balancing conductivity and stretchability, with a focus on innovative materials and structural designs to enhance performance and durability. ECFs are categorized by structural design (intrinsically stretchable and non-stretchable) and conductive materials (inorganic and organic), detailing advancements in micro/nano-structured conductive fillers and specialized microstructures. Applications in electrodes, strain sensors, transmitters, and actuators are showcased. The review also addresses manufacturing challenges, advocating for cost-effective, high-performance materials, scalable production methods, and a multidisciplinary approach combining empirical research, computational models, and machine learning. The future of ECFs lies in large-scale production with consistent quality, multifunctional integration, and leveraging AI-driven models for design and manufacturing. As research advances, ECFs are set to become fundamental in modern electronic applications, emphasizing the need for continued exploration and innovation.