Polyurethane (PU) foam is one of the most common materials used in the development of pressure relieving cushions. However, it suffers from reduced efficiency in terms of thermophysiological comfort, cost, recycling and importantly, creating a suitable environment for the prevention of pressure ulcers. The paper presents research carried out at the University of Bolton, in the development of pressure relieving cushion applications using three-dimensional (3D) warp-knitted spacer fabrics. This research includes the development of a novel technique for measuring pressure distribution while under simulated loading conditions. Using this system, novel and smart 3D knitted spacer cushions were developed, with the following features: (1) a shaped/contoured surface was able to redistribute high pressure points normally located in vulnerable areas of an immobile and seated person. (2) Peak pressures were reduced and distributed evenly over a much larger area of the cushion than PU foam. (3) They are well-ventilated, comfortable, washable and non-flammable and can be easily recycled.