Without the context, the question is most likely to refer to something to wear.
Using "he" would suggest that a customer is buying for somebody else (3rd person male), and has probably asked about a specific item. The shop assistant would then ask questions like "What is his size?". However, using "his" would apply whether the person is there or not - mother buying for a child, or wife buying for her husband etc.,
So, the answer is possibly neither! But use "What is his size?" instead.