How do I make UITableViewCell's ImageView a fixed size even when the image is smaller

It's not necessary to rewrite everything. I recommend doing this instead:

Post this inside your .m file of your custom cell.

- (void)layoutSubviews {
    [super layoutSubviews];
    self.imageView.frame = CGRectMake(0,0,32,32);
}

This should do the trick nicely. :]

For those of you who don't have a subclass of UITableViewCell:

- (UITableViewCell *)tableView:(UITableView *)tableView cellForRowAtIndexPath:(NSIndexPath *)indexPath {
 [...]

      CGSize itemSize = CGSizeMake(40, 40);
      UIGraphicsBeginImageContextWithOptions(itemSize, NO, UIScreen.mainScreen.scale);
      CGRect imageRect = CGRectMake(0.0, 0.0, itemSize.width, itemSize.height);
      [cell.imageView.image drawInRect:imageRect];
      cell.imageView.image = UIGraphicsGetImageFromCurrentImageContext();
      UIGraphicsEndImageContext();

 [...]
     return cell;
}

The code above sets the size to be 40x40.

Swift 2

    let itemSize = CGSizeMake(25, 25);
    UIGraphicsBeginImageContextWithOptions(itemSize, false, UIScreen.mainScreen().scale);
    let imageRect = CGRectMake(0.0, 0.0, itemSize.width, itemSize.height);
    cell.imageView?.image!.drawInRect(imageRect)
    cell.imageView?.image! = UIGraphicsGetImageFromCurrentImageContext();
    UIGraphicsEndImageContext();

Or you can use another(not tested) approach suggested by @Tommy:

- (UITableViewCell *)tableView:(UITableView *)tableView cellForRowAtIndexPath:(NSIndexPath *)indexPath {
 [...]

      CGSize itemSize = CGSizeMake(40, 40);
      UIGraphicsBeginImageContextWithOptions(itemSize, NO, 0.0)          
 [...]
     return cell;
}

Swift 3+

let itemSize = CGSize.init(width: 25, height: 25)
UIGraphicsBeginImageContextWithOptions(itemSize, false, UIScreen.main.scale);
let imageRect = CGRect.init(origin: CGPoint.zero, size: itemSize)
cell?.imageView?.image!.draw(in: imageRect)
cell?.imageView?.image! = UIGraphicsGetImageFromCurrentImageContext()!;
UIGraphicsEndImageContext();

The code above is the Swift 3+ version of the above.

Here's how i did it. This technique takes care of moving the text and detail text labels appropriately to the left:

@interface SizableImageCell : UITableViewCell {}
@end
@implementation SizableImageCell
- (void)layoutSubviews {
    [super layoutSubviews];

    float desiredWidth = 80;
    float w=self.imageView.frame.size.width;
    if (w>desiredWidth) {
        float widthSub = w - desiredWidth;
        self.imageView.frame = CGRectMake(self.imageView.frame.origin.x,self.imageView.frame.origin.y,desiredWidth,self.imageView.frame.size.height);
        self.textLabel.frame = CGRectMake(self.textLabel.frame.origin.x-widthSub,self.textLabel.frame.origin.y,self.textLabel.frame.size.width+widthSub,self.textLabel.frame.size.height);
        self.detailTextLabel.frame = CGRectMake(self.detailTextLabel.frame.origin.x-widthSub,self.detailTextLabel.frame.origin.y,self.detailTextLabel.frame.size.width+widthSub,self.detailTextLabel.frame.size.height);
        self.imageView.contentMode = UIViewContentModeScaleAspectFit;
    }
}
@end

...

- (UITableViewCell *)tableView:(UITableView *)tableView cellForRowAtIndexPath:(NSIndexPath *)indexPath {
    static NSString *CellIdentifier = @"Cell";

    UITableViewCell *cell = [tableView dequeueReusableCellWithIdentifier:CellIdentifier];
    if (cell == nil) {
        cell = [[[SizableImageCell alloc] initWithStyle:UITableViewCellStyleSubtitle reuseIdentifier:CellIdentifier] autorelease];
        cell.accessoryType = UITableViewCellAccessoryDisclosureIndicator;
    }

    cell.textLabel.text = ...
    cell.detailTextLabel.text = ...
    cell.imageView.image = ...
    return cell;
}