Large Language Models (LLMs) demonstrate strong capabilities in broad knowledge representation, yet they are inherently deficient in pixel-level perceptual understanding. Although the Segment Anything Model (SAM) represents a significant advancement in visual-prompt-driven image segmentation, it exhibits notable limitations in multi-mask prediction and category-specific segmentation tasks, and it cannot integrate all segmentation tasks within a unified model architecture. To address these limitations, we present X-SAM, a streamlined Multimodal Large Language Model (MLLM) framework that extends the segmentation paradigm from \textit{segment anything} to \textit{any segmentation}. Specifically, we introduce a novel unified framework that enables more advanced pixel-level perceptual comprehension for MLLMs. Furthermore, we propose a new segmentation task, termed Visual GrounDed (VGD) segmentation, which segments all instance objects with interactive visual prompts and empowers MLLMs with visual grounded, pixel-wise interpretative capabilities. To enable effective training on diverse data sources, we present a unified training strategy that supports co-training across multiple datasets. Experimental results demonstrate that X-SAM achieves state-of-the-art performance on a wide range of image segmentation benchmarks, highlighting its efficiency for multimodal, pixel-level visual understanding. Code is available at https://github.com/wanghao9610/X-SAM.