In the recent decade, pixelated CsI(Tl) scintillation films are developed for X-ray imaging to improve spatial resolution. Several methods have been reported but better performance is still required. In this work, CsI(Tl) films were prepared on specially designed patterned substrates with regular arrays of pits. Each CsI(Tl) micro-column locates in one pit. In this way, CsI(Tl) films with pixel-like columnar-matrix structure were achieved. Each pixel contains one micro-column and the size of pixel is the average diameter of the columns. Morphologies of the films were examined by scanning electron microscopy. Imaging performances of films dependent on their structure are discussed. The prepared CsI(Tl) films show superior image performance and may be well-coupled with pixelated photo sensors for X-ray imaging systems.