Halide perovskites have demonstrated great potential for next-generation X-ray detectors owing to their strong X-ray absorption, excellent charge-transport properties, tunable band structures, and low-cost processability. These advantages enable high-sensitivity, low-dose, and fast-response X-ray detection for medical imaging, security screening, and industrial inspection. Recently, heterostructure engineering has become an effective strategy for improving detector performance and stability by regulating band alignment, interfacial coupling, and carrier transport. In this review, we highlight recent advances in heterostructure-engineered halide perovskite X-ray detectors, including perovskite/perovskite and perovskite/functional-material heterostructures. Particular emphasis is placed on how heterointerfaces improve charge separation and transport, suppress recombination losses, inhibit ion migration, and enhance device stability and imaging performance. Finally, we discuss the remaining challenges and future opportunities for developing high-performance, stable, and scalable perovskite X-ray detection technologies.