Gd 2 SiO 5 :Ce (GSO:Ce) is a high-Z, nonhygroscopic fast emitting scintillator used in detectors of positron emission tomography (PET) systems. The purpose of this study was to evaluate the luminescence efficiency of GSO:Ce scintillator under irradiation conditions employed in X-ray medical imaging, since findings may be of value in novel applications such as computed tomography breast imaging or modern fast image producing X-ray computed tomography. To this aim the absolute luminescence efficiency (emitted light flux over X-ray exposure), the spectral matching factor (compatibility to optical detectors), and the effective efficiency (the product of absolute efficiency and spectral compatibility) were determined for X-ray tube voltages ranging from 20 to 140 kV. The efficiency of GSO:Ce was found to increase with increasing X-ray tube voltage, while the GSO:Ce spectrum, peaking at 440 and 490 nm, was found compatible to most optical detectors (photodiodes, photocathodes, and charge-coupled devices).