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Flexible pressure sensors are lightweight and highly sensitive, making them suitable for use in small portable devices to achieve precise measurements of tiny forces. This article introduces a low-cost and easy-fabrication strategy for piezoresistive flexible pressure sensors. By embedding silver nanowires into a polydimethylsiloxane layer with micro-pyramids on its surface, a flexible pressure sensor is created that can detect low pressure (17.3 Pa) with fast response (<20 ms) and high sensitivity (69.6 mA kPa−1). Furthermore, the pressure sensor exhibits a sensitive and stable response to a small amount of water flowing on its surface. On this basis, the flexible pressure sensor is innovatively combined with a micro-rotor to fabricate a novel urinary flow-rate meter (uroflowmeter), and results from a simulated human urination experiment show that the uroflowmeter accurately captured all the essential shape characteristics that were present in the pump-simulated urination curves. Looking ahead, this research provides a new reference for using flexible pressure sensors in urinary flow-rate monitoring. ARTICLE HIGHLIGHTS: • A flexible pressure sensor is presented based on a micro-pyramid array and silver nanowires and with low detection limit, high sensitivity, and fast response. • The sensor responds accurately and stably to human pulse signals and rapidly changing cyclic loads. • The sensor can accurately and sensitively detect dynamic water flow passing over its upper surface, and the uroflowmeter designed using it has considerably high detection accuracy. [ABSTRACT FROM AUTHOR]