Flexible electronic technology is one of the research hotspots, and numerous wearable devices have been widely used in our daily life. As an important part of wearable devices, flexible sensors can effectively detect various stimuli related to specific environments or biological species, having a very bright development prospect. Therefore, there has been lots of studies devoted to developing high-performance flexible pressure sensors. In addition to developing a variety of materials with excellent performances, the microstructure designs of materials can also effectively improve the performances of sensors, which has brought new ideas to scientists and attracted their attention increasingly. This paper will summarize the flexible pressure sensors based on material microstructure designs in recent years. The paper will mainly discuss the processing methods and characteristics of various sensors with different microstructures, and compare the advantages, disadvantages, and application scenarios of them. At the same time, the main application fields of flexible pressure sensors based on microstructure designs will be listed, and their future development and challenges will be discussed.