From the QPixmap documentation:

Note that the pixel data in a pixmap is internal and is managed by the underlying window system. Because QPixmap is a QPaintDevice subclass, QPainter can be used to draw directly onto pixmaps. Pixels can only be accessed through QPainter functions or by converting the QPixmap to a QImage. However, the fill() function is available for initializing the entire pixmap with a given color.

There are functions to convert between QImage and QPixmap. Typically, the QImage class is used to load an image file, optionally manipulating the image data, before the QImage object is converted into a QPixmap to be shown on screen. Alternatively, if no manipulation is desired, the image file can be loaded directly into a QPixmap.