Multifunctional wearable heaters have attracted much attention for their effective applications in personal thermal management and medical therapy. Compared to passive heating, Joule heating offers significant advantages in terms of reusability, reliable temperature control, and versatile coupling. Joule‐heated fabrics make wearable electronics smarter. This review critically discusses recent advances in Joule‐heated smart fabrics, focusing on various fabrication strategies based on material‐structure synergy. Specifically, various applicable conductive materials with Joule heating effect are first summarized. Subsequently, different preparation methods for Joule heating fabrics are compared, and then their various applications in smart clothing, healthcare, and visual indication are discussed. Finally, the challenges faced in developing these smart Joule heating fabrics and their possible solutions are discussed.