Smart textile fabrics have been widely investigated and used in flexible wearable electronics because of their unique structure, flexibility and breathability, which are highly desirable with integrated multifunctionality. Recent years have witnessed the rapid development of textile fiber-based flexible wearable devices. However, the pristine textile fibers still can't meet the high standards for practical flexible wearable devices, which calls for the development of some effective modification strategies. In this review, we summarize the recent advances in the flexible wearable devices based on the textile fibers, putting special emphasis on the design and modifications of textile fibers. In addition, the applications of textile fibers in various fields and the critical role of textile fibers are also systematically discussed, which include the supercapacitors, sensors, triboelectric nanogenerators, thermoelectrics, and other self-powered electronic devices. Finally, the main challenges that should be overcome and some effective solutions are also manifested, which will guide the future development of more effective textile fiber-based flexible wearable devices. Flexible wearable devices based on textile fibers are a technology that combines electronic components, sensors and textiles. It takes advantage of the softness and breathability of textile fibers to embed electronic components into textiles to achieve the functions of wearable devices. The modification of textile fibers can provide better comfort, functionality and durability for flexible wearable devices, and promote the development and application of wearable technology. image