Clickable ToolStripMenuItem Image

ContextMenuStrip ctxt = new ContextMenuStrip();

ToolStripMenuItem tsmi = new ToolStripMenuItem();
tsmi.Name = "Hello World";
tsmi.Image = Properties.Resources.MyIcon.ToBitMap();
tsmi.MouseUp += tsmi_MouseUp;

ctxt.Items.Add(tsmi);

private void tsmi_MouseUp(object sender, MouseEventArgs e)
{
    ToolStripMenuItem tsmi = (ToolStripMenuItem)sender;
    Rectangle iconRect = new Rectangle(e.Location, tsmi.Image.Size);

     if (iconRect.Contains(e.Location))
     {
          // do whatever you need to do here...
     }
}