The 2010 Astrophysics Decadal Survey recommended a significant technology development program towards realizing the scientific goals of the International X-ray Observatory (IXO). NASA has undertaken an X-ray mission concepts study to determine alternative approaches to accomplishing IXO's high ranking scientific objectives over the next decade given the budget realities, which make a flagship mission challenging to implement. The goal of the study is to determine the degree to which missions in various cost ranges from $300M to $2B could fulfill these objectives. The study process involved several steps. NASA released a Request for Information in October 2011, seeking mission concepts and enabling technology ideas from the community. The responses included a total of 14 mission concepts and 13 enabling technologies. NASA also solicited membership for and selected a Community Science Team (CST) to guide the process. A workshop was held in December 2011 in which the mission concepts and technology were presented and discussed. Based on the RFI responses and the workshop, the CST then chose a small group of notional mission concepts, representing a range of cost points, for further study. These notional missions concepts were developed through mission design laboratory activities in early 2012. The results of all these activities were captured in the final Xray mission concepts study report, submitted to NASA in July 2012. In this presentation, we summarize the outcome of the study. We discuss background, methodology, the notional missions, and the conclusions of the study report.