We show that nano-optical antennas are capable of controlling the luminescence induced by the absorption of x rays into matter. The x-ray-excited luminescence from a tiny scintillation cluster coupled to a horn nano-optical antenna is highly directed and determined by the antenna's geometrical parameters. Directionality is sufficiently high to efficiently outcouple the x-ray-excited luminescence to a narrow single-mode optical fiber, thus enabling ultracompact fiber-integrated x-ray sensors. Our nano-optically driven approach offers the possibility of x-ray profiling and dosimetry in ultra-confined environments, opening up new avenues in the fields of x-ray imaging, as well as medical and industrial endoscopy. With this study, to the best of our knowledge, nano-optical antennas make a first key contribution to the development of x-ray sensing protocols and architectures.