The invention discloses a large X-ray machine operating table arm support. The arm support is characterized in that a sliding sleeve is sleeved with a lateral rack rod, a base sleeve is fixedly connected with the sliding sleeve through a fixing clamping strip, a middle sleeve meshes with the base sleeve through a tooth combination, a head sleeve is installed at the front end of the middle sleeve, an adjusting head is installed in front of the head sleeve, the head sleeve is connected with a handle, a head core and a tail core are installed in an inner cavity of the head sleeve and in the inner cavity of the middle sleeve respectively, an inner hole is formed in the base sleeve, the outer diameter portion of an arm support guide rod is sleeved with a head core sleeve opening and a tail core sleeve opening, a head core screw is adjusted to be connected with a head core connection screw hole through a head sleeve connection hole, a tail core bolt is in threaded connection with a tail core connection screw hole through the sliding sleeve, a middle sleeve bolt is clamped into an adjusting groove through a middle sleeve bolt hole, a head sleeve bolt is clamped into the adjusting groove through a head sleeve bolt hole, and a handle adjusting bolt is connected with the adjusting head through a handle installation hole. The arm support has the advantages that the structure is simple, manufacturing is easy, materials are easy to find, the cost is low, detachment and installation are quick, installation and use are convenient, the arm support is safe and reliable, pain of patients is reduced, and the comfort of the patients is improved.