The purpose of the present study was to evaluate, under X-ray medical imaging conditions, the X-ray luminescence efficiency (XLE) and the optical quantum gain (OQG) of the Gd2SiO5:Ce scintillator in single crystal form, suitable for tomographic applications. Intrinsic physical properties and light emission characteristics of the Gd2SiO5:Ce scintillator, were also studied. Both experimental and Monte Carlo techniques were used. Various X-ray tube voltages (40–140 kV), currently employed in X-ray imaging applications, were used. XLE was found to vary slowly with X-ray tube voltage from (0.021±0.003) to (0.017±0.003). OQG varied from (317±18) to (466±23) light photons per incident X-ray. These values were adequately high for imaging applications using the particular energy range. Additionally, it was found by Monte Carlo simulations that for crystal thicknesses higher than 0.5 cm both XLE and OQG reached saturation levels, indicating that higher thickness crystals are of no practical use in X-ray medical imaging.