A video telephony terminal and an image transmission method thereof are provided. During video communication, the video telephony terminal generates a still image having a desired pattern in a user-desired region and provides a terminal of another party with an image achieved by synthesizing the generated still image with an image captured by a built-in camera. Upon establishing video communication, a change to the desired pattern in the user-desired region of the camera-captured image can be made quickly, or a desired message can be inserted into the captured image and can be transmitted in real time.