Sound plays a crucial role in the perception of the world. It allows to communicate, learn, and detect potential dangers, diagnose diseases, and much more. However, traditional acoustic sensors are limited in their form factors, being rigid and cumbersome, which restricts their potential applications. Recently, acoustic sensors have made significant advancements, transitioning from rudimentary forms to wearable devices and smart everyday clothing that can conform to soft, curved, and deformable surfaces or surroundings. In this review, the latest scientific and technological breakthroughs with insightful analysis in materials, physics, design principles, fabrication strategies, functions, and applications of flexible and wearable acoustic sensing technology are comprehensively explored. The new generation of acoustic sensors that can recognize voice, interact with machines, control robots, enable marine positioning and localization, monitor structural health, diagnose human vital signs in deep tissues, and perform organ imaging is highlighted. These innovations offer unique solutions to significant challenges in fields such as healthcare, biomedicine, wearables, robotics, and metaverse. Finally, the existing challenges and future opportunities in the field are addressed, providing strategies to advance acoustic sensing technologies for intriguing real-world applications and inspire new research directions.