We report the design, fabrication and characterization of a carbon nanotube enabled open-type X-ray system for medical imaging. We directly grew the carbon nanotubes used as electron emitter for electron gun on a non-polished raw metallic rectangular-rounded substrate with an area of 0.1377 cm2 through a plasma enhanced chemical vapor deposition system. The stable field emission properties with triode electrodes after electrical aging treatment showed an anode emission current of 0.63 mA at a gate field of 7.51 V/μm. The 4.5-inch cubic shape open type X-ray system was developed consisting of an X-ray aperture, a vacuum part, an anode high voltage part, and a field emission electron gun including three electrodes with focusing, gate and cathode electrodes. Using this system, we obtained high-resolution X-ray images accelerated at 42–70 kV voltage by digital switching control between emitter and ground electrode.