An X-ray diagnostic apparatus according to an embodiment includes an imaging apparatus and a processor. The imaging apparatus includes an X-ray tube configured to generate an X ray; and an X-ray detector configured to detect an X ray that has been emitted from the X-ray tube and passed through a subject. The processor obtains an examination protocol including an imaging condition corresponding to contents of an examination for the subject, obtains a camera image in which the subject has been captured, and determines whether at least one examination item corresponding to the examination protocol is executable based on first geometric information and second geometric information, the first geometric information including a geometric positional relation between the subject and the imaging apparatus associated with the examination protocol, and the second geometric information including a geometric positional relation between the subject and the imaging apparatus detected based on the camera image.