<p>Thanks to the high quantum efficiency, large migration lifetime, excellent X-ray absorption capability, and ease of crystal growth, perovskite scintillators have received widespread attention in recent years and have become highly competitive X-ray detection scintillators. Compared with traditional inorganic scintillators, the tunable structure and diverse chemical composition of perovskite scintillators are unique advantages in optimizing their scintillation performance. Fully understanding the relationship between scintillation characteristics with structure and chemical composition of perovskite scintillators is the key to achieve high-sensitivity detection and highresolution imaging. The latest progress and future prospect of key performance indicators such as light yield and spatial resolution in perovskite X-ray indirect detection and imaging are reviewed herein. First, the basic principles of X-ray indirect detection and the key performance parameters of X-ray indirect detectors are discussed. Then, the methods to improve the light yield of perovskite scintillators are discussed from the aspects of the characteristics of perovskite materials themselves, the introduction of ion doping to adjust the perovskite structure, and the improvement of scintillation preparation processes. We further discuss how to suppress fluorescence crosstalk to improve the spatial resolution of X-ray imaging from the aspects of material size, scintillation preparation process, and scintillation structure. Finally, we emphasize the challenges that current perovskite scintillators still face and provide prospects for their future development.</p>