Although three-dimensional metal halide perovskite (ABX₃) single crystals are promising next-generation materials for radiation detection, state-of-the-art perovskite X-ray detectors include methylammonium as A-site cations, limiting the operational stability. Previous efforts to improve the stability using formamidinium–caesium-alloyed A-site cations usually sacrifice the detection performance because of high trap densities. Here we successfully solve this trade-off between stability and detection performance by synergistic composition engineering, where we include A-site alloys to decrease the trap density and B-site dopants to release the microstrain induced by A-site alloying. As such, we develop high-performance perovskite X-ray detectors with excellent stability. Our X-ray detectors exhibit high sensitivity of (2.6 ± 0.1) × 10⁴ μC Gy_air⁻¹ cm⁻² under 1 V cm⁻¹ and ultralow limit of detection of 7.09 nGy_air s⁻¹. In addition, they feature long-term operational stability over half a year and impressive thermal stability up to 125 °C. We further demonstrate the promise of our perovskite X-ray detectors for low-bias portable applications with high-quality X-ray imaging and monitoring prototypes.