Cardiovascular diseases have become a severe threat to human health. Fortunately, most of them can be effectively assessed and prevented through long-term monitoring of cardiovascular signals. Wearable medical sensors play an essential role in monitoring human physiological health, which are heading towards ultra-low power consumption, high sensitivity and stability. Furthermore, a comfortable wearable sensor also needs to be flexible and breathable. Here, a self-powered textile pulse sensor (STPS) based on triboelectric nanogenerator (TENG) is demonstrated for real-time monitoring of the radial artery pulse waveform. STPS can directly convert tiny pressure signals into electrical signals with excellent linearity (R2 = 0.996), low detection limit, and long-term stable performance (5×104 cycles). The flexible textile-based STPS can be conformally attached to the human body for continuously and stably recording physiological mechanical signals, which is expected to be utilized in the personalized cardiovascular pulse monitoring wearable devices in the Internet of Things era.