Whereas cotton as an abundant natural cellulose has been widely used for sustainable and skin-friendly textiles and clothes, developing cotton fabrics with smart functions that could respond to various stimuli is still eagerly desired while remaining a great challenge. Herein, smart multiresponsive cotton fabric with hierarchically copper nanowire interwoven MXene conductive networks that are seamlessly assembled along a 3D woven fabric template for efficient personal healthcare and thermal comfort regulation is successfully developed. The robust hierarchically interwoven conductive network was "glued" and protected by organic conductive polymer poly(3,4-ethylenedioxythiophene) along a 3D interconnected fabric template to enhance interfacial adherent and environmental stability. Benefiting from the robust multiresponsive hierarchically interwoven conductive network, smart cotton fabric exhibits real-time response to various external stimuli (light/electrical/heat/temperature/stress), and the details of human activities can be accurately recognized and monitored. Furthermore, the porous structure of 3D smart fabric induced strong capillary force and confinement to phase change materials PEG, which exhibits a wide range of phase transition temperatures for efficient thermal comfort regulation. After further encapsulation with transparent fluorosilicone resin, the smart cotton fabric exhibits excellent self-cleaning performance with water/oil repellent. The smart multiresponsive cotton fabrics hold great promise in next-generation wearable systems for efficient personal healthcare and thermal management.