High-energy radiation detection and imaging technology has significant applications in high-energy physics research, medical imaging, and industrial monitoring. Lead-free metal halides exhibit exceptional potential for conducting indirect detection of high-energy radiation due to their characteristics of low toxicity, strong stability, high light yield, and large Stokes shift. This paper reviews the most recent advances in lead-free metal halide scintillator materials for X-ray imaging. Subsequently, it lists the most important parameters of scintillator performance and introduces the production procedures for single crystal, powder, and nanocrystal scintillators. Furthermore, it discusses the manufacturing of scintillator films with improved performance, focusing on large-area flexible scintillator films and the coupling with microstructures. Finally, it discusses current challenges and opportunities for enhancing X-ray imaging using lead-free metal halide scintillator materials.