Individuals experiencing gait disfunction such as the elderly those with peripheral nervous system damage or individuals with Parkinson’s disease face a heightened risk of physical injury due to imbalanced weight distribution. Despite recent advancements in wearable movement trackers, there remains a significant need for a reliable long term plantar pressure monitoring system. While some existing devices measure pressure characteristics many are hindered by limitations in spatial resolution, sensitivity and the presence of bulky peripherals. Here we introduce a flexible smart insole system that integrates screen printed nanomaterials to create a high density piezoresistive sensor array enabling accurate plantar pressure measurement during daily activities. To ensure scalable and cost-effective manufacturing we utilize a screen-printing method to fabricate 173 carbon-based sensors directly onto a flexible insole circuit. The printed sensors demonstrate a remarkable sensitivity of −0.322 kPa–1, surpassing previous benchmarks. When combined with a wearable mobile communication circuit this system offers a comprehensive analysis of the user’s plantar pressure distribution. Experimental studies conducted with human subjects showcase the smart insole’s real-time monitoring capabilities in common daily ambulation scenarios. The integration of high spatial resolution, exceptional sensitivity and a fully mobile wearable system holds significant promise for enhancing outcomes across various applications from healthcare to athletics.