The International X-Ray Observatory (IXO) will address fundamental questions in astrophysics, including When did the first SMBH form? How does large scale structure evolve? What happens close to a black hole? What is the connection between these processes? What is the equation of state of matter at supra-nuclear density? This report presents an overview of the assessment study phase of the IXO candidate ESA L-class Cosmic Vision mission. We provide a description of the IXO science objectives, the mission implementation and the payload. The performance will offer more than an order of magnitude improvement in capability compared with Chandra and XMM-Newton. This observatory-class facility comprises a telescope with highly nested grazing incidence optics with a performance requirement of 2.5 sq.m. of effective area at 1.25 keV with a 5 PSF. There is an instrument complement that provides capabilities in imaging, spatially resolved spectroscopy, timing, polarimetry and high resolution dispersive spectroscopy. Since earlier submissions to the Astro2010 Decadal Survey, substantial technological progress has been made, particularly in the mirror development. Risk reduction measures and important programmatic choices have also been identified. An independent internal Technical and Programmatic Review has also been carried out by ESA, concluding with positive recommendations. Subject to successful conclusion of agreements between the partner space agencies, IXO is fully ready to proceed to further definition, moving towards an eventual launch in 2021-2022.