diff --git a/homeassistant/helpers/selector.py b/homeassistant/helpers/selector.py
index f9af2eb1d718..db8fe76b0d0a 100644
--- a/homeassistant/helpers/selector.py
+++ b/homeassistant/helpers/selector.py
@@ -136,6 +136,13 @@ def _validate_selector_reorder_config(config: Any) -> Any:
     return config
 
 
+def _validate_media_selector_config(config: Any) -> Any:
+    """Validate media selectors with image_upload option."""
+    if config.get("image_upload") and not config.get("accept"):
+        raise probatio.Invalid("image_upload can only be used when accept is not empty")
+    return config
+
+
 def make_selector_config_schema(schema_dict: dict | None = None) -> probatio.Schema:
     """Make selector config schema."""
     if schema_dict is None:
@@ -1358,6 +1365,7 @@ class MediaSelectorConfig(BaseSelectorConfig, total=False):
 
     accept: list[str]
     multiple: bool
+    image_upload: bool
 
 
 @SELECTORS.register("media")
@@ -1366,11 +1374,15 @@ class MediaSelector(Selector[MediaSelectorConfig]):
 
     selector_type = "media"
 
-    CONFIG_SCHEMA = make_selector_config_schema(
-        {
-            probatio.Optional("accept"): [str],
-            probatio.Optional("multiple", default=False): cv.boolean,
-        }
+    CONFIG_SCHEMA = probatio.All(
+        make_selector_config_schema(
+            {
+                probatio.Optional("accept"): [str],
+                probatio.Optional("multiple", default=False): cv.boolean,
+                probatio.Optional("image_upload", default=False): cv.boolean,
+            }
+        ),
+        _validate_media_selector_config,
     )
     DATA_SCHEMA = probatio.Schema(
         {
diff --git a/tests/helpers/test_selector.py b/tests/helpers/test_selector.py
index 188871d07e47..f002412ba497 100644
--- a/tests/helpers/test_selector.py
+++ b/tests/helpers/test_selector.py
@@ -1935,6 +1935,35 @@ def test_theme_selector_schema(schema, valid_selections, invalid_selections) ->
                 },
             ),
         ),
+        (
+            {
+                "accept": ["image/*"],
+                "image_upload": True,
+            },
+            (
+                {
+                    "media_content_id": "abc",
+                    "media_content_type": "def",
+                },
+                {
+                    "media_content_id": "abc",
+                    "media_content_type": "def",
+                    "metadata": {},
+                },
+            ),
+            (
+                None,
+                "abc",
+                {},
+                {
+                    # We do not allow entity_id when accept is set
+                    "entity_id": "sensor.abc",
+                    "media_content_id": "abc",
+                    "media_content_type": "def",
+                    "metadata": {},
+                },
+            ),
+        ),
     ],
 )
 def test_media_selector_schema(schema, valid_selections, invalid_selections) -> None:
@@ -1942,6 +1971,24 @@ def test_media_selector_schema(schema, valid_selections, invalid_selections) ->
     _test_selector("media", schema, valid_selections, invalid_selections)
 
 
+@pytest.mark.parametrize(
+    "schema",
+    [
+        # image_upload can only be used when accept is not empty
+        {"image_upload": True},
+        {"image_upload": True, "accept": []},
+    ],
+)
+def test_media_selector_schema_error(
+    schema: dict[str, bool | list[str]],
+) -> None:
+    """Test media selector with invalid config."""
+    with pytest.raises(
+        probatio.Invalid, match="image_upload can only be used when accept is not empty"
+    ):
+        selector.validate_selector({"media": schema})
+
+
 @pytest.mark.parametrize(
     ("schema", "valid_selections", "invalid_selections"),
     [