The X-ray luminescence efficiency of laboratory-prepared YVO4: Eu screens and their spectral compatibility to common optical detectors were studied under medical fluoroscopy conditions. YVO4: Eu screens were prepared by sedimentation and with different coating thickness. Luminescence efficiency of the YVO4: Eu screens was measured at various X-ray tube voltages (50–250 kVp) and for screens of different coating thicknesses (20–180 mg/cm2). Spectral response was also measured and spectral matching factors between the YVO4: Eu screens and some common optical detectors (photocathodes, photodiodes, photographic emulsion) were calculated. Experimental results on efficiency were fitted by formulas of the theoretical model developed by Hamaker and Ludwig in order to determine phosphor intrinsic X-ray-to-light conversion efficiency and intrinsic optical characteristics, such as coefficients related to light scattering and absorption. Although the luminescence efficiency of YVO4: Eu screens was found to be relatively low (3–11 μM s/mR m2), the matching factor of YVO4 : Eu screens with some red sensitive optical detectors was excellent, of the order of 0.96. High spectral compatibility may indicate that YVO4: Eu scintillators could be used in medical image detectors.