using System;
using System.Collections.Generic;
using System.Linq;
using System.Web;

namespace PWS.UI.Handler
{
    /// <summary>
    /// Summary description for PhotoHandler
    /// </summary>
    public class PhotoHandler : IHttpHandler
    {

        public void ProcessRequest(HttpContext context)
        {
            context.Response.ContentType = "text/plain";
            context.Response.Write("Hello World");
        }

        public bool IsReusable
        {
            get
            {
                return false;
            }
        }
    }
}

using System;
using System.Data.SqlClient;
using System.Diagnostics;
using System.Drawing;
using System.Drawing.Drawing2D;
using System.Drawing.Imaging;
using System.Globalization;
using System.IO;
using System.Web;

namespace PWS.UI.Handler
{
    /// <summary>
    /// Summary description for PhotoHandler
    /// </summary>
    public class PhotoHandler : IHttpHandler
    {

        /// <summary>
        /// بازیابی تصویر اصلی از بانک اطلاعاتی
        /// </summary>
        /// <param name="photoId">کد تصویر</param>
        /// <returns></returns>
        private byte[] GetImageFromDatabase(int photoId)
        {
            using (var connection = new SqlConnection("ConnectionString"))
            {
                using (var command = new SqlCommand("Select Photo From tblPhotos Where Id = @PhotoId", connection))
                {
                    command.Parameters.Add(new SqlParameter("@PhotoId", photoId));
                    connection.Open();
                    var result = command.ExecuteScalar();
                    return ((byte[])result);
                }
            }
        }

        /// <summary>
        /// بازیابی فایل از دیسک
        /// </summary>
        /// <param name="photoId">با فرض اینکه نام فایل این است</param>
        /// <returns></returns>
        private byte[] GetImageFromDisk(string photoId /* or somting */)
        {
                using (var sourceStream = new FileStream("Original File Path + id", FileMode.Open, FileAccess.Read))
                {
                    return StreamToByteArray(sourceStream);
                }
        }

        /// <summary>
        /// Streams to byte array.
        /// </summary>
        /// <param name="inputStream">The input stream.</param>
        /// <returns></returns>
        /// <exception cref="System.ArgumentException"></exception>
        static byte[] StreamToByteArray(Stream inputStream)
        {
            if (!inputStream.CanRead)
            {
                throw new ArgumentException();
            }

            // This is optional
            if (inputStream.CanSeek)
            {
                inputStream.Seek(0, SeekOrigin.Begin);
            }

            var output = new byte[inputStream.Length];
            int bytesRead = inputStream.Read(output, 0, output.Length);
            Debug.Assert(bytesRead == output.Length, "Bytes read from stream matches stream length");
            return output;
        }

        /// <summary>
        /// Enables processing of HTTP Web requests by a custom HttpHandler that implements the <see cref="T:System.Web.IHttpHandler" /> interface.
        /// </summary>
        /// <param name="context">An <see cref="T:System.Web.HttpContext" /> object that provides references to the intrinsic server objects (for example, Request, Response, Session, and Server) used to service HTTP requests.</param>
        public void ProcessRequest(HttpContext context)
        {
            // Set up the response settings
            context.Response.ContentType = "image/jpeg";
            context.Response.Cache.SetCacheability(HttpCacheability.Public);
            context.Response.BufferOutput = false;

            // مرحله اول
            int size = 0;
            switch (context.Request.QueryString["Size"])
            {
                case "S":
                    size = 100; //100px
                    break;
                case "M":
                    size = 198; //198px
                    break;
                case "L":
                    size = 500; //500px
                    break;
            }
            byte[] changedImage;
            var id = Convert.ToInt32(context.Request.QueryString["PhotoId"]);
            byte[] sourceImage = GetImageFromDatabase(id);
            // یا
            //byte[] sourceImage = GetImageFromDisk(id.ToString(CultureInfo.InvariantCulture));

            //مرحله 2
            if (size != 0)  //غیر از حالت واقعی تصویر
            {
                changedImage = Helpers.ResizeImageFile(sourceImage, size, ImageFormat.Jpeg);
            }
            else
            {
                changedImage = (byte[])sourceImage.Clone();
            }

            // مرحله 3
            if (changedImage == null) return;
            context.Response.AddHeader("Content-Length", changedImage.Length.ToString(CultureInfo.InvariantCulture));
            context.Response.BinaryWrite(changedImage);
        }

        public bool IsReusable
        {
            get
            {
                return false;
            }
        }
    }
}

PhotoHandler.ashx?PhotoId=10&Size=S

مانند

<img src='PhotoHandler.ashx?PhotoId=10&Size=S' alt='تصویر ازمایشی' />