A method for registering a three-dimensional image data record of a target region of a patient with a two-dimensional x-ray image is provided. The method includes selecting at least one rigid reference structure with an associated contour; establishing a two-dimensional gradient x-ray image and a three-dimensional gradient data record of the image data record; finding a neighborhood in the gradient x-ray image from a plurality of neighborhoods extending about test points for a plurality of contour points; establishing local two-dimensional displacement information by comparison of the contour points with the associated comparison points; establishing movement parameters of a three-dimensional movement model describing a movement of the target region between recording of the image data record and the x-ray image from the local two-dimensional displacement information; and establishing a registration transformation describing the registration by correcting the test transformation based on the movement parameters.