Abstract: The CT X-ray tube is a core high-value consumable component of CT. Its reliability directly determines imaging quality and normal operation of CT. The article discusses the current status and gaps in CT tube reliability research both domestically and internationally, explains the key points of technical evaluation, including the setting of reliability indicators, evaluation paths based on verification and modeling, as well as test design, performance testing, and failure analysis for reliability testing. It also proposes reliability improvement strategies to provide guidance for enhancing the reliability of domestically produced CT tubes.