This review provides an in-depth analysis of X-ray detection technologies using organic-inorganic hybrid (OIH) perovskites, all-inorganic and lead-free perovskite single crystals (SCs), thin/thick films, and wafers. The study systematically examines the advancements in synthesis methods, structural modifications, and device architectures to enhance radiation sensing performance. Key findings indicate that SC-based devices outperform film and wafer-based devices due to lower trap density, higher resistivity, and larger carrier mobility and lifetime. SCs exhibit superior sensitivity and the lowest detectable dose rate (LDDR) compared to traditional X-ray detectors like amorphous selenium and cadmium zinc telluride (CZT). Film-based devices are limited by defect formation, while wafer-based devices suffer from voids that impede charge carrier movement. Structural modifications have been shown to improve device performance and stability. The review also discusses the fundamental properties of materials and devices, including radiation attenuation ratio, ionization energy, charge collection efficiency, dark current, sensitivity, limit of detection, and mobility-lifetime product. Various fabrication techniques for active layers, such as inverse-temperature crystallization (ITC), temperature-lowering crystallization (TLC), slow solvent evaporation (SSE), anti-solvent vapor-assisted crystallization (AVC), hydrothermal synthesis, vapor transport, and Bridgman synthesis, are detailed. Additionally, the review covers thin and thick film growth techniques like spin coating, spray deposition, aerosol-liquid-solid (ALS), dissolution and recrystallization, inkjet printing, doctor blade method, and bar-assisted meniscus shearing. The development of perovskite materials for X-ray detection, including OIH, all-inorganic, and lead-free perovskites, is discussed, highlighting their potential in direct detection and imaging applications. The review concludes with a comparison of the performance of perovskite-based detectors with conventional devices, emphasizing the superior performance of perovskite materials in terms of sensitivity and LDDR.This review provides an in-depth analysis of X-ray detection technologies using organic-inorganic hybrid (OIH) perovskites, all-inorganic and lead-free perovskite single crystals (SCs), thin/thick films, and wafers. The study systematically examines the advancements in synthesis methods, structural modifications, and device architectures to enhance radiation sensing performance. Key findings indicate that SC-based devices outperform film and wafer-based devices due to lower trap density, higher resistivity, and larger carrier mobility and lifetime. SCs exhibit superior sensitivity and the lowest detectable dose rate (LDDR) compared to traditional X-ray detectors like amorphous selenium and cadmium zinc telluride (CZT). Film-based devices are limited by defect formation, while wafer-based devices suffer from voids that impede charge carrier movement. Structural modifications have been shown to improve device performance and stability. The review also discusses the fundamental properties of materials and devices, including radiation attenuation ratio, ionization energy, charge collection efficiency, dark current, sensitivity, limit of detection, and mobility-lifetime product. Various fabrication techniques for active layers, such as inverse-temperature crystallization (ITC), temperature-lowering crystallization (TLC), slow solvent evaporation (SSE), anti-solvent vapor-assisted crystallization (AVC), hydrothermal synthesis, vapor transport, and Bridgman synthesis, are detailed. Additionally, the review covers thin and thick film growth techniques like spin coating, spray deposition, aerosol-liquid-solid (ALS), dissolution and recrystallization, inkjet printing, doctor blade method, and bar-assisted meniscus shearing. The development of perovskite materials for X-ray detection, including OIH, all-inorganic, and lead-free perovskites, is discussed, highlighting their potential in direct detection and imaging applications. The review concludes with a comparison of the performance of perovskite-based detectors with conventional devices, emphasizing the superior performance of perovskite materials in terms of sensitivity and LDDR.