A pulse oximeter is a common medical instrument used for noninvasively monitoring arterial oxygen saturation (SpO2). Currently, the fingertip-type pulse oximeter is the prevalent type of pulse oximeter used. However, it is inconvenient for long-term monitoring, such as that under motion. In this study, a wearable and wireless finger base-type pulse oximeter was designed and implemented using the tissue optical simulation technique and the Monte Carlo method. The results revealed that a design involving placing the light source at 135°-165° and placing the detector at 75°-90° or 90°-105° yields the optimal conditions for measuring SpO2. Finally, the wearable and wireless finger base-type pulse oximeter was implemented and compared with the commercial fingertip-type pulse oximeter. The experimental results showed that the proposed optimal finger base-type pulse oximeter design can facilitate precise SpO2 measurement.