Abstract: In a medical X-ray diagnostic installation and a method for operating same, an X-ray source has a filter means optionally introducible into its beam path and emits X-rays which strike a detector having individual pixel elements and which generates image signals pixel-by-pixel dependent on the received radiation. The detector is followed by a signal processing chain which includes processing meansfor image generation and output, first and only image exposure of the examination subject initially ensues without the filter means introduced into the beam path, after which the image signals obtained from one or more picture element regions of the received image are processed pixel-by-pixel for generating a calculated image corresponding to the image of those regions which would be obtained with the filter means in the beam path, using signals which identify a position of the filter means in the beam path.