With the modernization of traditional Chinese medicine (TCM), creating devices to digitalize aspects of pulse diagnosis has proved to be challenging. The currently available pulse detection devices usually rely on external pressure devices, which are either bulky or poorly integrated, hindering their practical application. In this work, we propose an innovative wearable active pressure three-channel pulse monitoring device based on TCM pulse diagnosis methods. It combines a flexible pressure sensor array, flexible airbag array, active pressure control unit, advanced machine learning approach, and a companion mobile application for human–computer interaction. Due to the high sensitivity (460.1 kPa−1), high linearity (R2 > 0.999) and flexibility of the flexible pressure sensors, the device can accurately simulate finger pressure to collect pulse waves (Cun, Guan, and Chi) at different external pressures on the wrist. In addition, by measuring the change in pulse wave amplitude at different pressures, an individual’s blood pressure status can be successfully predicted. This enables truly wearable, actively pressurized, continuous wireless dynamic monitoring of wrist pulse health. The innovative and integrated design of this pulse monitoring platform could provide a new paradigm for digitizing aspects of TCM and other smart healthcare systems.