Bright and fast scintillators are highly crucial for high-speed X-ray imaging in the medical diagnostic radiology including angiography and cardiac computed tomography. The CsPbBr3 nanocrystal scintillator featuring a nanosecond radioluminescence decay time is a promising candidate. However, it suffers from a substantial photon self-absorption limiting the light output, and being bright and fast simultaneously is difficult. Here we design and in-situ synthesize multi-site ZnS(Ag)-CsPbBr3 heterostructures to modulate the bright and fast features of scintillators. We find external energy from ZnS(Ag) can effectively transfer to CsPbBr3 based on the non-radiative Förster resonance energy transfer, resulting in a light yield of 40,000 photons MeV−1. By combing a radioluminescence decay time of 36 ns and a spatial resolution of 30 lp mm−1, the scintillator enables high-speed X-ray imaging at 200 frames per second. This study showcases the structure design is significant for obtaining bright and fast perovskite scintillators for the real-time X-ray imaging.