Skin cancer is the most common and preventable of cancers in the world and is caused most frequently by excess ultraviolet (UV) radiation. Best preventive practices in the form of sunscreen, protective apparel, and changes in behavior are effective but are limited by their users' low commitment levels. The most recent innovation is UV sensors based on textile, which is a cutting-edge concept where the sensors are implemented on the textile itself so that the UV exposure can be sensed in real-time and non-invasively. The review summarizes the recent achievements in textile-based UV dosimetry, and the mechanisms, such as photochromic dyes, nanomaterials, printed electronics, and fiber-level functionalization, are outlined. Systems reported show high sensitivity to both UV-A and UV-B radiation, providing comfort, affordability, and wearability benefits over the traditional electronic dosimeters. Nevertheless, there are still issues with washability, calibration error, environmental stability, and compatibility issues at large-scale manufacturing. The potential uses are found in occupational safety, sports and recreational apparel, pediatric apparel, and consumer wellness products. Additionally, it can be incorporated into the Internet of Things (IoT) to provide population-level exposure analytics and predictive healthcare planning that adheres to Industry 4.0 paradigms. Sustainability considerations such as material choice, scalable processing, and lifecycle analysis are also important in providing long-term commercial sustainability and environmental stewardship. The integration of UV-sensing technologies in the fabrics of common wearables would transform preventative health care, decrease the incidence of UV-related skin cancers by a long margin, and create an active paradigm in the management of personal health.