An X-ray inspection machine and a method for tire expansion and spin driving. A vertical inspection machine expands the tire outwards from the bead part for positioning, centering, and spin driving, so as to improve the stability of the tire during high-speed spin, thereby improving imaging quality in X-ray inspection, improving X-ray inspection quality and enhancing the efficiency. The X-ray inspection machine comprises: a lead chamber; an X-ray running device; an imaging system running device; a tire-expanding and spin-driving device, having a rack and at least one set of guide rods, each side of each guide rod being mounted on the rack by a mounting bracket; guide bushings, co-axially sleeved on the guide rods by a bearing to bear the tire, so as to drive the tire to spin by pressing the tire bead; a connection rod, the center of which is fixedly and axially provided on the rack, one end of which is connected to a hinge pin for axially arranging the mounting bracket, and the other end of which is connected to a slide rack; the slide rack, moving along the straight line back and forth by a first driving device on the rack; and a second driving device, for being connected to the guide brushings and driving the guide brushings to move axially to drive the tire to spin.