Optimum characteristics of digital X-ray sensor components were analyzed to develop intra- oral dental digital X-ray image sensor using indirect method. Parametric analysis was carried out to optimize the phosphor thickness and the fiber optic plate (FOP) coupling to charge coupled device (CCD). X-ray absorption and light diffusion in the phosphor layer were analyzed by the Monte Carlo method. Real time X-ray image was obtained with prototype X- ray image sensor using general CCD camera with 1∼10 Ip/mm resolution. It has been previously shown that large resolution degradation in X-ray images was caused by miss alignment of FOP to CCD and optical adhesive selection. In this study, we reported that X-ray image quality was greatly improved by using optimized characteristics of alignment device and phosphor thickness.