Abstract Genotype-to-phenotype association studies typically use macroscopic physiological measurements or molecular readouts as quantitative traits. There are comparatively few suitable quantitative traits available between cell and tissue length scales, a limitation that hinders our ability to identify variants affecting phenotype at many clinically informative levels. Here we show that quantitative image features, automatically extracted from histopathological imaging data, can be used for image Quantitative Trait Loci (iQTL) mapping and variant discovery. Using thyroid pathology images, clinical metadata, and genomics data from the Genotype and Tissue Expression (GTEx) project, we establish and validate a quantitative imaging biomarker for immune cell infiltration. A total of 100,215 variants were selected for iQTL profiling, and tested for genotype-phenotype associations with our quantitative imaging biomarker. Significant associations were found in HDAC9 and TXNDC5. We validated the TXNDC5 association using GTEx cis -expression QTL data, and an independent hypothyroidism dataset from the Electronic Medical Records and Genomics network. One Sentence Summary We use a histopathological image QTL analysis to identify genomic variants associated with immune cell infiltration.