This review discusses the advancements in smart Janus textiles, which have asymmetric wettability, for biofluid management in wearable applications. The authors introduce the design configurations and fabrication approaches of Janus textiles, including asymmetric generation and decoration strategies. They highlight their diverse applications in personal thermal management, sweat sensors, hemostatic wound dressings, and protective equipment. These textiles offer innovative solutions for directional sweat transport, enhanced cooling and humidity control, and antibacterial properties. The review also addresses current limitations in durability, biocompatibility, and manufacturing scalability, along with emerging opportunities in the field of smart Janus textiles. The discussion covers advanced strategies, materials, and associated opportunities and challenges in this dynamic field.This review discusses the advancements in smart Janus textiles, which have asymmetric wettability, for biofluid management in wearable applications. The authors introduce the design configurations and fabrication approaches of Janus textiles, including asymmetric generation and decoration strategies. They highlight their diverse applications in personal thermal management, sweat sensors, hemostatic wound dressings, and protective equipment. These textiles offer innovative solutions for directional sweat transport, enhanced cooling and humidity control, and antibacterial properties. The review also addresses current limitations in durability, biocompatibility, and manufacturing scalability, along with emerging opportunities in the field of smart Janus textiles. The discussion covers advanced strategies, materials, and associated opportunities and challenges in this dynamic field.