diff --git a/litellm/litellm_core_utils/token_counter.py b/litellm/litellm_core_utils/token_counter.py
index 858b078d626..ccfce0e4133 100644
--- a/litellm/litellm_core_utils/token_counter.py
+++ b/litellm/litellm_core_utils/token_counter.py
@@ -646,6 +646,24 @@ def _validate_anthropic_content(content: Mapping[str, Any]) -> type:
     return expected_cls
 
 
+def _anthropic_image_source_data(source: Mapping[str, str]) -> str:
+    """
+    Resolve an Anthropic image `source` to the data string `calculate_img_tokens` prices.
+
+    Returns "" for a `file` source, whose bytes the proxy cannot resolve locally.
+    """
+    source_type: Final = source.get("type")
+    if source_type == "base64":
+        data: Final = source.get("data")
+        if not data:
+            return ""
+        media_type: Final = source.get("media_type") or "image/png"
+        return f"data:{media_type};base64,{data}"
+    if source_type == "url":
+        return source.get("url") or ""
+    return ""
+
+
 def _count_anthropic_content(
     content: Mapping[str, Any],
     count_function: TokenCounterFunction,
@@ -714,6 +732,13 @@ def _count_content_list(
             elif c["type"] == "image_url":
                 image_url = c.get("image_url")
                 num_tokens += _count_image_tokens(image_url, use_default_image_token_count)
+            elif c["type"] == "image":
+                source = c.get("source")
+                num_tokens += calculate_img_tokens(
+                    data=_anthropic_image_source_data(source) if isinstance(source, dict) else "",
+                    mode="auto",
+                    use_default_image_token_count=use_default_image_token_count,
+                )
             elif c["type"] in ("tool_use", "tool_result"):
                 num_tokens += _count_anthropic_content(
                     c,
@@ -742,7 +767,8 @@ def _count_content_list(
                 content_type = c.get("type", type(c).__name__) if isinstance(c, dict) else type(c).__name__
                 raise ValueError(
                     f"Invalid content item type: {content_type}. "
-                    f"Expected str or dict with 'type' field (text, image_url, tool_use, tool_result, thinking, tool_reference)."
+                    f"Expected str or dict with 'type' field "
+                    f"(text, image_url, image, tool_use, tool_result, thinking, tool_reference)."
                 )
         return num_tokens
     except Exception as e:
diff --git a/tests/test_litellm/litellm_core_utils/test_token_counter.py b/tests/test_litellm/litellm_core_utils/test_token_counter.py
index a2590dbca2d..701a1accd5f 100644
--- a/tests/test_litellm/litellm_core_utils/test_token_counter.py
+++ b/tests/test_litellm/litellm_core_utils/test_token_counter.py
@@ -1160,3 +1160,123 @@ def test_count_content_list_rejects_unknown_type():
     message = str(exc_info.value)
     assert "Invalid content item type: totally_unknown_block" in message
     assert "tool_reference" in message
+
+
+@pytest.mark.parametrize(
+    "source",
+    [
+        {"type": "base64", "media_type": "image/png", "data": "iVBORw0KGgo="},
+        {"type": "url", "url": "https://example.com/image.png"},
+        {"type": "file", "file_id": "file-abc123"},
+    ],
+    ids=["base64", "url", "file"],
+)
+def test_token_counter_with_anthropic_image_block(source):
+    """
+    Anthropic-native `image` blocks must NOT raise, for every source variant.
+
+    Before this fix `_count_content_list` raised
+    `Invalid content item type: image`. That 500s /v1/messages/count_tokens and
+    /utils/token_counter, and it makes the router's context-window pre-call
+    check swallow the error and return every deployment unfiltered, so an
+    oversized prompt carrying an image is dispatched upstream instead of being
+    rejected locally.
+    """
+    from litellm.constants import DEFAULT_IMAGE_TOKEN_COUNT
+
+    messages = [
+        {
+            "role": "user",
+            "content": [
+                {"type": "text", "text": "What is in this image?"},
+                {"type": "image", "source": source},
+            ],
+        }
+    ]
+
+    tokens = token_counter(
+        model="anthropic/claude-sonnet-4-5-20250929",
+        messages=messages,
+        use_default_image_token_count=True,
+    )
+    assert tokens > DEFAULT_IMAGE_TOKEN_COUNT, (
+        f"Expected the image block to contribute tokens, got {tokens}"
+    )
+
+
+def test_anthropic_image_block_matches_equivalent_image_url():
+    """
+    An Anthropic `image` block must price identically to the OpenAI `image_url`
+    block carrying the same bytes, so the count does not depend on which
+    endpoint shape the caller used.
+    """
+    anthropic_messages = [
+        {
+            "role": "user",
+            "content": [
+                {
+                    "type": "image",
+                    "source": {
+                        "type": "base64",
+                        "media_type": "image/png",
+                        "data": "iVBORw0KGgo=",
+                    },
+                }
+            ],
+        }
+    ]
+    openai_messages = [
+        {
+            "role": "user",
+            "content": [
+                {
+                    "type": "image_url",
+                    "image_url": {"url": "data:image/png;base64,iVBORw0KGgo="},
+                }
+            ],
+        }
+    ]
+
+    anthropic_tokens = token_counter(
+        model="anthropic/claude-sonnet-4-5-20250929", messages=anthropic_messages
+    )
+    openai_tokens = token_counter(
+        model="anthropic/claude-sonnet-4-5-20250929", messages=openai_messages
+    )
+    assert anthropic_tokens == openai_tokens
+
+
+def test_anthropic_image_block_nested_in_tool_result():
+    """
+    An `image` block nested inside a `tool_result.content` list must be counted
+    too. `_count_anthropic_content` recurses back into `_count_content_list`, so
+    the nested case failed for the same reason the top-level one did.
+    """
+    messages = [
+        {
+            "role": "user",
+            "content": [
+                {
+                    "type": "tool_result",
+                    "tool_use_id": "toolu_01",
+                    "content": [
+                        {
+                            "type": "image",
+                            "source": {
+                                "type": "base64",
+                                "media_type": "image/png",
+                                "data": "iVBORw0KGgo=",
+                            },
+                        }
+                    ],
+                }
+            ],
+        }
+    ]
+
+    tokens = token_counter(
+        model="anthropic/claude-sonnet-4-5-20250929",
+        messages=messages,
+        use_default_image_token_count=True,
+    )
+    assert tokens > 0