Stretchable composite conductive fibers (SCCFs) exhibit remarkable conductivity, stretchability, breathability, and biocompatibility, making them ideal candidates for wearable electronics and bioelectronics. The exploitation of SCCFs in electronic devices requires a careful balance of many aspects, including material selection and process methodologies, to address the complex challenges associated with their electrical and mechanical properties. In this review, we elucidate the conductive mechanism of SCCFs and summarize strategies for integrating various conductors with stretchable fibers, emphasizing the primary challenges in fabricating highly conductive fibers. Furthermore, we explore the multifaceted applications of SCCFs-based frameworks in wearable electronic devices. This review aims to emphasize the significance of SCCFs and offers insights into their conductive mechanisms, material selection, manufacturing technologies, and performance improvement. Hopefully, it can guide the innovative development of SCCFs and broaden their application potential.