<p>This study presents a novel approach for fabricating a piezo-resistive smart textile sensor using neoprene fabric and microneedling techniques. By incorporating microneedling, conductive particles were effectively introduced into the neoprene structure, overcoming the limitations of traditional dip-coating methods. The initial resistance of the sensor decreased significantly from 288.83 kΩ (0 cycles) to 0.87 kΩ (120 cycles), demonstrating the enhanced conductivity achieved through micro-perforation. In addition, the resistance change ratio increased with microneedling cycles, peaking at 0.77 (60 cycles) before decreasing at 120 cycles, aligning with 3D compressive percolation theory. Stress–strain analysis revealed that mechanical properties remained stable despite micro-perforations, with compressive stress ranging from 27–40.7&#xa0;kPa. Furthermore, water resistance tests confirmed that the microneedling process preserved the waterproof nature of neoprene, making it suitable for wearable applications in aquatic environments or extreme weather conditions. These findings highlight microneedling as an effective fabrication method for high-performance smart textile sensors. Future research will focus on optimizing microneedling parameters and expanding applications in smart wearables, including waterproof health monitoring systems and protective gear for rescue operations.</p>