A model of X-ray CsI(Tl) scintillation screen based on the macroporous silicon is established, and the influence of X-ray energy on the X-ray CsI (Tl) scintillation screen’s light output is simulated and analyzed. An X-ray scintillation screen with a period of 10 μm and a side length of 8 μm was prepared, and an X-ray imaging device was constructed. The X-ray images of different X-ray source-tube voltages were measured. The light output of the X-ray scintillation screen was analyzed using MATLAB software. The results show that an increase in the thickness of the scintillation screen increases the average gray value of the scintillation screen, which is consistent with the simulation results.