Smart Janus textiles with asymmetric wettability have shown great potential in wearable applications due to their ability to manage biofluids efficiently. This review summarizes recent advances in smart Janus textiles for biofluid control and monitoring, focusing on wearable technologies. The design configurations and fabrication approaches of Janus textiles, including asymmetric generation and decoration strategies, are introduced. These textiles have diverse applications in personal thermal management, sweat sensors, hemostatic wound dressings, and protective equipment. They offer innovative solutions for directional sweat transport, enhancing cooling and humidity control, and providing antibacterial properties. Current limitations in durability, biocompatibility, and manufacturing scalability are discussed, along with emerging opportunities in the field of smart Janus textiles. Smart textiles have played a critical role in the development of point-of-care medicine, enabling real-time monitoring of health parameters. However, wearable devices face challenges in comfort and skin compatibility, particularly during extended wear. Issues such as poor breathability and heat dissipation can lead to skin irritation. Moisture regulation is vital for maintaining skin health and preventing infections. Asymmetric wettability, where a material displays different wettability characteristics on each side, is a significant attribute. Inspired by nature, such as the desert beetle, smart Janus textiles have emerged as a high-performance functional material category with applications in water harvesting, oil-water separation, smart clothing, and medical applications. The design and preparation of smart Janus textiles involve three configurations: A-on-B, A-and-B, and A-to-B. Asymmetric generation and decoration are two strategies used to prepare Janus materials. Electrospinning is extensively used for Janus fabric preparation due to its anisotropic wetting properties and accurate controllability. Asymmetric modification serves as another approach for obtaining Janus membranes. The development of Janus fibrous membranes with asymmetrical superwettability has addressed issues related to membrane permeability. Janus textiles with varying wettability are used in several applications, such as thermal regulation, sweat detection, hemostatic dressings, and wearable protection. Thermal management textiles balance heat exchange between the human body and the environment, using microstructures with surface wettability to determine liquid transport and sweat evaporation efficiency. Sweat evaporation is an important way of human thermal management, with trilayered textiles demonstrating effective moisture transport. Janus textiles also show promise in sweat sensors, where they enable efficient separation and directed movement of sweat toward the sensor area. Electrochemical sweat sensing has emerged as a noninvasive, efficient health monitoring method. Janus textiles have been developed for electrochemical sweat sensing, allowing efficient collection and guidance of sweat from the skin to the electrode surface. Colorimetric sweat sensing measures color changes to analyze sweat composition, with Janus fabrics offering targeted confinement of sweat droplets for accurate detection. Hemostatic materials are crucial in wound healing and bleeding control. Janus gauze has been developed to hasten coagulation by exploitingSmart Janus textiles with asymmetric wettability have shown great potential in wearable applications due to their ability to manage biofluids efficiently. This review summarizes recent advances in smart Janus textiles for biofluid control and monitoring, focusing on wearable technologies. The design configurations and fabrication approaches of Janus textiles, including asymmetric generation and decoration strategies, are introduced. These textiles have diverse applications in personal thermal management, sweat sensors, hemostatic wound dressings, and protective equipment. They offer innovative solutions for directional sweat transport, enhancing cooling and humidity control, and providing antibacterial properties. Current limitations in durability, biocompatibility, and manufacturing scalability are discussed, along with emerging opportunities in the field of smart Janus textiles. Smart textiles have played a critical role in the development of point-of-care medicine, enabling real-time monitoring of health parameters. However, wearable devices face challenges in comfort and skin compatibility, particularly during extended wear. Issues such as poor breathability and heat dissipation can lead to skin irritation. Moisture regulation is vital for maintaining skin health and preventing infections. Asymmetric wettability, where a material displays different wettability characteristics on each side, is a significant attribute. Inspired by nature, such as the desert beetle, smart Janus textiles have emerged as a high-performance functional material category with applications in water harvesting, oil-water separation, smart clothing, and medical applications. The design and preparation of smart Janus textiles involve three configurations: A-on-B, A-and-B, and A-to-B. Asymmetric generation and decoration are two strategies used to prepare Janus materials. Electrospinning is extensively used for Janus fabric preparation due to its anisotropic wetting properties and accurate controllability. Asymmetric modification serves as another approach for obtaining Janus membranes. The development of Janus fibrous membranes with asymmetrical superwettability has addressed issues related to membrane permeability. Janus textiles with varying wettability are used in several applications, such as thermal regulation, sweat detection, hemostatic dressings, and wearable protection. Thermal management textiles balance heat exchange between the human body and the environment, using microstructures with surface wettability to determine liquid transport and sweat evaporation efficiency. Sweat evaporation is an important way of human thermal management, with trilayered textiles demonstrating effective moisture transport. Janus textiles also show promise in sweat sensors, where they enable efficient separation and directed movement of sweat toward the sensor area. Electrochemical sweat sensing has emerged as a noninvasive, efficient health monitoring method. Janus textiles have been developed for electrochemical sweat sensing, allowing efficient collection and guidance of sweat from the skin to the electrode surface. Colorimetric sweat sensing measures color changes to analyze sweat composition, with Janus fabrics offering targeted confinement of sweat droplets for accurate detection. Hemostatic materials are crucial in wound healing and bleeding control. Janus gauze has been developed to hasten coagulation by exploiting