With an ideal comfort level, sensitivity, reliability, and user‐friendliness, wearable sensors are making great contributions to daily health care, nursing care, early disease discovery, and body monitoring. Some wearable sensors are imparted with hierarchical and uneven microstructures, such as microneedle structures, which not only facilitate the access to multiple bio‐analysts in the human body but also improve the abilities to detect feeble body signals. In this paper, we present the promising applications and latest progress of functional microneedles in wearable sensors. We begin by discussing the roles of microneedles as sensing units, including how the signals are captured, converted, and transmitted. We also introduce the microneedle‐like structures as power units, which depend on triboelectric or piezoelectric effects, etc. Finally, we summarize the cutting‐edge applications of microneedle‐based wearable sensors in biophysical signal monitoring and biochemical analyte detection, and provide critical thinking on their future perspectives.