Image-to-image regression is an important learning task, used frequently in biological imaging. Current algorithms, however, do not generally offer statistical guarantees that protect against a model's mistakes and hallucinations. To address this, we develop uncertainty quantification techniques with rigorous statistical guarantees for image-to-image regression problems. In particular, we show how to derive uncertainty intervals around each pixel that are guaranteed to contain the true value with a user-specified confidence probability. Our methods work in conjunction with any base machine learning model, such as a neural network, and endow it with formal mathematical guarantees -- regardless of the true unknown data distribution or choice of model. Furthermore, they are simple to implement and computationally inexpensive. We evaluate our procedure on three image-to-image regression tasks: quantitative phase microscopy, accelerated magnetic resonance imaging, and super-resolution transmission electron microscopy of a Drosophila melanogaster brain.