Silk fabric-based wearable electronics stand among the most effective materials for the electronic skin function, due to their flexibility, robust mechanical features, and bio-compatibility. However, the development of fabric sensors is restricted by limited resilience and the weak binding force of conductive materials to fabrics. Herein, a general strategy is developed for designing SF wearable devices with high elasticity and conductivity, combining the macroscopic design of three-dimensional SF structure, microscopic plasma-activated β-FeOOH scaffolds and in situ polymerized polypyrrole. Significantly, the fabric exhibits a maximum tensile strain of up to 30%, high conductivity (resistivity of 0.3 Ω·cm), fast response in sensing (50 ms), and excellent durability (> 1500 cycles). The possible mechanism of plasma activation of akaganeite scaffolds to produce zero-valent iron and induce pyrrole polymerization is analyzed. In addition, the e-textiles are demonstrated for personal-care management, including motion recognition, information interaction and electric heating. This work provides a novel guide to constructing advanced fabric-sensor devices capable of high conductivity and elasticity, which are expected to be applied in the fields of health monitoring, smart homes, and virtual reality interaction. The three-dimensional conductive silk wearable devices (3D-CSWD) combine redesigning the fabric structure, employing plasma treatment to activate β-FeOOH scaffolds, and inducing in situ polymerization of polypyrrole. These fabric devices are capable of withstanding large mechanical stretching cycles and maintain high conductivity after washing, which can be used to monitor a wide range of human body motions, including pulse monitoring, breathing monitoring, swallowing actions, and wrist and finger bending movements. Furthermore, they can be used for electric heating and information exchange by transmitting morse code.