An X-ray diagnostic apparatus according to an embodiment includes a first imaging system, a second imaging system, and processing circuitry. The first imaging system holds a first X-ray tube and a first X-ray detector in a rotatable manner. The second imaging system holds a second X-ray tube and a second X-ray detector in a rotatable manner, and rotating centers, which are capable to set independently, between the first imaging system and the second imaging system. The processing circuitry makes a rotating center of the first imaging system and the rotating center of the second imaging system substantially equivalent to each other when a rotation imaging program using the first imaging system and the second imaging system is selected.