In this paper, we propose an image enhancement algorithm combining non-subsampled shearlet transform and gradient-domain guided filtering to address the problems of low resolution, noise amplification, missing details, and weak edge gradient retention in the X-ray image enhancement process. First, we decompose histogram equalization and nonsubsampled shearlet transform to the original image. We get a low-frequency sub-band and several high-frequency sub-bands. Adaptive gamma correction with weighting distribution is used for the low-frequency sub-band to highlight image contour information and improve the overall contrast of the image. The gradient-domain guided filtering is conducted for the high-frequency sub-bands to suppress image noise and highlight detail and edge information. Finally, we reconstruct all the effectively processed sub-bands by the inverse non-subsampled shearlet transform and obtain the final enhanced image. The experimental results show that the proposed algorithm has good results in X-ray image enhancement, and its objective index also has evident advantages over some classical algorithms.