In one embodiment, An X-ray CT apparatus includes: a rotating body and processing circuitry configured to extract an anatomical landmark from a medical image of an object acquired by a first scan, identify a shape of an anatomical site of the object based on the anatomical landmark, and set scanning conditions of a second scan based on the shape of the anatomical site, the second scan including a tilt scan in which a scan is performed under a condition where the rotating body is tilted, the scanning conditions including at least a tilt angle of the tilt scan.