How can I insert an image with iTextSharp in an existing PDF?

If you want to change the contents of an existing PDF file and add extra content such as watermarks, pagenumbers, extra headers, PdfStamper is the object you need. I have successfully used the following code to insert an image into an existing pdf file to a given absolute position:

using System.IO;
using iTextSharp.text;
using iTextSharp.text.pdf;

class Program
{
    static void Main(string[] args)
    {
        using (Stream inputPdfStream = new FileStream("input.pdf", FileMode.Open, FileAccess.Read, FileShare.Read))
        using (Stream inputImageStream = new FileStream("some_image.jpg", FileMode.Open, FileAccess.Read, FileShare.Read))
        using (Stream outputPdfStream = new FileStream("result.pdf", FileMode.Create, FileAccess.Write, FileShare.None))
        {
            var reader = new PdfReader(inputPdfStream);
            var stamper = new PdfStamper(reader, outputPdfStream);
            var pdfContentByte = stamper.GetOverContent(1);

            Image image = Image.GetInstance(inputImageStream);
            image.SetAbsolutePosition(100, 100);
            pdfContentByte.AddImage(image);
            stamper.Close();
        }
    }
}

When you insert the image you have the possibility to resize it. You can take a look at transformation matrix in the iTextSharp documentation.