A 3D X-ray detector for imaging of 30–200 keV photons is described. It comprises a stack of semitransparent structured scintillators, where each scintillator is a regular array of waveguides in silicon, and with pores filled with CsI. The performance of the detector is described theoretically and explored in detail through simulations. The resolution of a single screen is shown to be determined only by the pitch, at least up to 100 keV. In comparison to conventional homogenous screens an improvement in efficiency by a factor 5–15 is obtainable. The cross-talk between screens in the 3D detector is shown to be negligible. The concept of such a 3D detector enables ray tracing and super resolution algorithms to be applied. Realized pore geometries have a lower aspect ratio than used in simulations and the roughness of the pore walls gives a 13% decrease in waveguide efficiency. Compared to currently used regular scintillators with similar resolution an efficiency increase by a factor 4 has been found for the structured scintillator.