This research presents a novel cooling electronic textile (CET) designed for outdoor health monitoring. The CET integrates passive cooling technology with pressure-sensing functionality, enabling reliable and accurate tracking of physiological signals in hot environments while maintaining a consistently cool device temperature. The CET features a spectrally selective passive cooling structure and a hierarchical sensing construction, resulting in superior sensitivity (6.67×10³ kPa⁻¹) and remarkable stability. It also exhibits excellent wearable properties, including flexibility, lightweightness, and thermal comfort, with a maximum temperature reduction of 21°C. Unlike existing devices, the CET maintains stable performance even in rugged external environments, offering accurate signal output during overheating. The CET's core design relies on passive radiative cooling, minimizing solar absorption and maximizing thermal radiation into outer space through the long-wave infrared atmospheric window (8–13 μm). This results in high solar reflectivity (~90%) and thermal emissivity (~92%). The CET is fabricated using commercially available cotton fabrics, carbonized under a hydrogen atmosphere, and integrated with a conductive silver electrode. The resulting textile has a thickness of around 2 mm and is capable of sensing pressure in the range of 12.5 Pa–20 kPa and 20–100 kPa. The CET demonstrates exceptional passive cooling performance, optimal textile structural design, high sensitivity, and a broad sensing range in rugged external conditions, making it an ideal candidate for next-generation electronic textiles, particularly for outdoor applications.This research presents a novel cooling electronic textile (CET) designed for outdoor health monitoring. The CET integrates passive cooling technology with pressure-sensing functionality, enabling reliable and accurate tracking of physiological signals in hot environments while maintaining a consistently cool device temperature. The CET features a spectrally selective passive cooling structure and a hierarchical sensing construction, resulting in superior sensitivity (6.67×10³ kPa⁻¹) and remarkable stability. It also exhibits excellent wearable properties, including flexibility, lightweightness, and thermal comfort, with a maximum temperature reduction of 21°C. Unlike existing devices, the CET maintains stable performance even in rugged external environments, offering accurate signal output during overheating. The CET's core design relies on passive radiative cooling, minimizing solar absorption and maximizing thermal radiation into outer space through the long-wave infrared atmospheric window (8–13 μm). This results in high solar reflectivity (~90%) and thermal emissivity (~92%). The CET is fabricated using commercially available cotton fabrics, carbonized under a hydrogen atmosphere, and integrated with a conductive silver electrode. The resulting textile has a thickness of around 2 mm and is capable of sensing pressure in the range of 12.5 Pa–20 kPa and 20–100 kPa. The CET demonstrates exceptional passive cooling performance, optimal textile structural design, high sensitivity, and a broad sensing range in rugged external conditions, making it an ideal candidate for next-generation electronic textiles, particularly for outdoor applications.