Bombyx mori silk fibers exhibit significant potential for applications in smart textiles, such as fiber sensors, fiber actuators, optical fibers, and energy harvester. Silk fibroin (SF) from B. mori silkworm fibers can be reconstructed/functionalized at the mesoscopic scale during refolding from the solution state into fibers. This facilitates the mesoscopic functionalization by engaging functional seeds in the refolding of unfolded SF molecules. In particular, SF solutions can be self-assembled into regenerated fiber devices by artificial spinning technologies, such as wet spinning, dry spinning, microfluidic spinning, electrospinning, and direct writing. Meso-functionalization manipulates the SF property from the mesoscopic scale, transforming the original silk fibers into smart fiber devices with smart functionalities, such as sensors, actuators, optical fibers, luminous fibers, and energy harvesters. In this review, the progress of mesoscopic structural construction from SF materials to fiber electronics/photonics is comprehensively summarized, along with the spinning technologies and fiber structure characterization methods. The applications, prospects, and challenges of smart silk fibers in textile devices for wearable personalized healthcare, self-propelled exoskeletons, optical and luminous fibers, and sustainable energy harvesters are also discussed.