X-ray nanochemistry studies how to use nanomaterials and particularly how to create new nanomaterials to increase the effects of X-rays such as chemical reactivity, damage to cells, tumor destruction, scintillation and more. The increase, also called enhancement, can be categorized into several groups, and the current categorization of enhancement follows a natural division of physical, chemical and biological enhancement based on how nanomaterials behave under X-ray irradiation. In physical enhancement, electrons released from atoms in the nanomaterials upon X-ray ionization interact with the nanomaterials and surrounding media to increase the effects. Scintillation also belongs to this category. Chemical enhancement results when reactive oxygen species (ROS) or reactive radical intermediates (RRI) produced in aqueous solutions under X-ray irradiation interact with the surface of catalytic nanomaterials to increase the effects. When the damage of cells is enhanced through biological pathways beyond the abovementioned physical or chemical enhancement due to the presence of nanomaterials under X-ray irradiation, the enhancement is called biological enhancement. Works supporting this systematic categorization, the reported values of these enhancements, and important aspects of the development of enhancement in the X-ray nanochemistry framework are given and discussed in this perspective.