This review summarizes the advanced design of flexible textile actuators for smart wearable applications. Smart wearables equipped with flexible actuators can autonomously respond and adapt to environmental changes. Fibrous textiles are promising platforms for integrating flexible actuators due to their compliance, lightweight, and programmable structures. The review covers the design concepts, materials, architectures, stimuli, and applications of textile actuators in smart wearables over the past five years. It discusses actuating materials, textile architecture configurations, external stimuli, and their applications in smart wearables. The review also highlights design challenges for next-generation smart wearables, including actuation performance, human body fit, integrated microelectronic systems, and safety. The review emphasizes the potential of flexible textile actuators in smart wearables, including their ability to sense and respond to environmental changes. The review also discusses various actuating materials, such as shape memory alloys (SMAs), polymers, and carbon nanotubes (CNTs), and their applications in smart wearables. The review also covers textile-forming technologies, including knitting, weaving, braiding, and knotting, which are used to create flexible textile actuators. The review highlights the importance of surface modification and bonding techniques in enhancing the performance of textile actuators. The review also discusses the diverse types of textile actuators, including electric, thermal, optical, humidity, bladder, and magnetic actuators, and their applications in smart wearables. The review concludes that flexible textile actuators have great potential for smart wearable applications due to their ability to sense and respond to environmental changes.This review summarizes the advanced design of flexible textile actuators for smart wearable applications. Smart wearables equipped with flexible actuators can autonomously respond and adapt to environmental changes. Fibrous textiles are promising platforms for integrating flexible actuators due to their compliance, lightweight, and programmable structures. The review covers the design concepts, materials, architectures, stimuli, and applications of textile actuators in smart wearables over the past five years. It discusses actuating materials, textile architecture configurations, external stimuli, and their applications in smart wearables. The review also highlights design challenges for next-generation smart wearables, including actuation performance, human body fit, integrated microelectronic systems, and safety. The review emphasizes the potential of flexible textile actuators in smart wearables, including their ability to sense and respond to environmental changes. The review also discusses various actuating materials, such as shape memory alloys (SMAs), polymers, and carbon nanotubes (CNTs), and their applications in smart wearables. The review also covers textile-forming technologies, including knitting, weaving, braiding, and knotting, which are used to create flexible textile actuators. The review highlights the importance of surface modification and bonding techniques in enhancing the performance of textile actuators. The review also discusses the diverse types of textile actuators, including electric, thermal, optical, humidity, bladder, and magnetic actuators, and their applications in smart wearables. The review concludes that flexible textile actuators have great potential for smart wearable applications due to their ability to sense and respond to environmental changes.