The invention provides an X-ray collimation and positioning regulation device and system. The X-ray collimation and positioning regulation device comprises a sealed cavity, a light path collimation regulation mechanism, a horizontal driving structure and a vertical driving structure, wherein the light path collimation regulation mechanism comprises an upper lead sheet and a lower lead sheet and further comprises an upper XY mobile platform and a lower XY mobile platform, which can be driven by the horizontal driving structure to move relatively; an upper through hole is formed in the upper XY mobile platform and a lower through hole is formed in the lower XY mobile platform; the upper lead sheet is mounted at an upper opening end of the upper through hole and the lower lead sheet is mounted at a lower opening end of the lower through hole; light passing holes through which X rays pass are formed in the geometric centers of the upper lead sheet and the lower lead sheet; the hole diameter of the light passing hole of the lower lead sheet is less than that of the light passing hole of the upper lead sheet; the vertical driving structure acts to drive the X-ray collimation and positioning regulation device to move up and down. A collimation relation between the upper through hole and the lower through hole is changed through the relative movement of the upper XY mobile platform and the lower XY mobile platform, so that the luminous flux of the X rays is regulated and the resolution ratio is improved.