Fibers and textiles are attractive substrates for constructing wearables, the devices rely on conductive fibers with good stretchability to realize electrical conductivity and mechanical adaptivity. The exploitation of stretchable composite conductive fibers (SCCFs) requires diverse strategies in material options and process methods, tackling the challenge in balancing electrical and mechanical properties for ultrafine fiber, which highly determine the properties and applications. In this article, first the working mechanism and advantages of the SCCFs in wearables is introduced. Second, different conductive fillers as well as their respective incorporation strategies and performance superiorities in fabricating SCCFs are systematically summarized. Third, the integration routes of the conductive fillers in SCCFs are indicated and compared, presenting different fabrication strategies and mechanisms for improving the performance of SCCFs. Thereafter, the typical applications of SCCFs in energy management, sensing, actuators, heaters, and displays are highlighted. Accordingly, the main challenges of SCCFs for wearable applications are indicated, and the possible solutions for challenges tackling are proposed. This review prepared aims to highlight the importance of SCCFs in wearables, and provides insights in terms of mechanism, materials, fabrication, and performance improvement, paving a referable way to promote the innovative exploitation and development of SCCFs, extending the application scenarios.