X-ray detection technology is a widely used technology in non-destructive inspections, including medical diagnosis, safety inspection and quality inspection. Metal halide perovskites are ideal X-ray absorption materials because of their easy preparation, low defect density, high resistivity and high carrier mobility-lifetime product. Starting from the fundamental interactions between X-ray and absorption material, detector structure and evaluation metrics, this review analyses the advantages of metal halide perovskites as X-ray absorption material and further introduces the synthesis methods of metal halide perovskites. Next, this review summarizes the recent progress of X-ray detectors based on metal halide perovskites in recent years, and systematically discusses how to improve the sensitivity and detection limit. The integration methods of X-ray detector and read out circuit, and the research progress of X-ray imaging detectors in recent years are also overviewed. Finally, the challenges and outlooks of X-ray detection and imaging based on metal halide perovskites are proposed.