• Metal halide perovskites exhibit exceptional light yield and X-ray sensitivity, positioning them as leading candidates for next-generation X-ray detection.
• Engineering intrinsic properties such as light yield and response times is crucial for optimizing scintillator performance.
• Innovative strategies including stacked structures, waveguide effects, and flexible scintillators enhance radioluminescent light management for high-resolution imaging.
• The review outlines a roadmap for future development, emphasizing the transformative potential of MHPs in high-performance X-ray detection systems.