Thermoregulation has substantial implications for energy consumption and human comfort and health. However, cooling technology has remained largely unchanged for more than a century and still relies on cooling the entire space regardless of the number of occupants. Personalized thermoregulation by thermoelectric devices (TEDs) can markedly reduce the cooling volume and meet individual cooling needs but has yet to be realized because of the lack of flexible TEDs with sustainable high cooling performance. Here, we demonstrate a wearable TED that can deliver more than 10°C cooling effect with a high coefficient of performance (COP > 1.5). Our TED is the first to achieve long-term active cooling with high flexibility, due to a novel design of double elastomer layers and high-ZT rigid TE pillars. Thermoregulation based on these devices may enable a shift from centralized cooling toward personalized cooling with the benefits of substantially lower energy consumption and improved human comfort.