Microwave-induced thermoacoustic (TA) imaging, combining high microwave contrast with high ultrasonic resolution has the potential to revolutionize applications such as continuous healthcare monitoring, point-of-care imaging, and biometric authentication. However, the size, cost, and integration of a high-power microwave transmitter is a key bottleneck in making TA imaging truly portable, affordable, and ubiquitous. Toward that end, this work presents a compact 4.9-GHz pulsed power amplifier (PA) with a 4.87-mm<sup>2</sup> active area implemented in a 55-nm BiCMOS technology, operating in a duty-cycled mode and achieving 37.3-dBm peak output power—the highest demonstrated peak power in PAs fabricated on a silicon substrate with deep submicron CMOS integration. We also reconstruct the first known high-fidelity TA images of tissue phantoms using an integrated silicon PA.