It's easier than it looks.
I used freeware called Andrea Mosaic, I think, to create it.
I uploaded all the pictures and gave the program parameters such as how big the pictures should be and how many times a picture can be repeated or flipped. It does the rest. I did several creations before getting one I liked well enough.
Than we took it to a sign shop and had it printed because we wanted a very large size. (20 x 24 or larger, I can't remember.)
We did three copies and framed them. One for us and this was our Christmas present to the other two families we went with (MIL and SIL.)
Here's one my sister did for us a few years back. Hers is actually more impressive because she used a larger picture size and she hand drew the Mickey mosaic pattern.
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WOW! That is amazing! Thanks for the info!

We received so many compliments! We even saw a other families wearing similar designs.