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Elastic pressure sensors play a crucial role in the digital economy, such as in health care systems and human–machine interfacing. However, the low sensitivity of these sensors restricts their further development and wider application prospects. This issue can be resolved by introducing microstructures in flexible pressure-sensitive materials as a common method to improve their sensitivity. However, complex processes limit such strategies. Herein, a cost-effective and simple process was developed for manufacturing surface microstructures of flexible pressure-sensitive films. The strategy involved the combination of MXene–single-walled carbon nanotubes (SWCNT) with mass-produced Polydimethylsiloxane (PDMS) microspheres to form advanced microstructures. Next, the conductive silica gel films with pitted microstructures were obtained through a 3D-printed mold as flexible electrodes, and assembled into flexible resistive pressure sensors. The sensor exhibited a sensitivity reaching 2.6 kPa⁻¹ with a short response time of 56 ms and a detection limit of 5.1 Pa. The sensor also displayed good cyclic stability and time stability, offering promising features for human health monitoring applications.