X-ray/CT image registration plays a pivotal role in enhancing surgical navigation success rates. However, challenges stemming from sparse and noisy X-ray image features, coupled with the complexities of multi-parameter optimization, impose limitations on existing methods in terms of registration accuracy and efficiency. In response, this paper presents an innovative approach—a fast X-ray/CT image registration method based on perspective projection triangular features(F-PPTF). By leveraging the conformal nature of perspective projection, the proposed method constructs perspective projection triangular features with rotation, translation, and scale invariance using point feature descriptors. Diverging from multi-parameter iterative optimization techniques, this approach achieves the decoupling of the six transformation parameters. This decoupling simplifies computational intricacies, thereby facilitating swift registration. Experimental evaluations conducted on synthetic and real X-ray images reveal an average rotational absolute error of 0.41°, an average translational absolute error of 1.16 mm, and an average registration time of 14.89 s. In comparison to conventional registration methodologies, the method presented in this paper demonstrates pronounced superiority in terms of both registration accuracy and efficiency, thereby exhibiting heightened potential for broader applicability.