Okay. PDF uses points. 1 point is 1/72 of an inch. 125mm = 4.921 inches. 4.921 * 72 = 354.312 points. Fractional points are just fine.
And it looks like TCPDF abstracts much of the work away unless you do some serious digging, which you don't need to do.
According to the docs for Image, all you need to do is specify the dimension you want to fit, and it'll scale the other proportionally:
// draw an image that is 125mm wide, and scaled to whatever height is needed
// to maintain the same proportions
TCPDF::image($path, $xloc, $yloc,
354.321, 0, ''/*no link*/,
''/*use path extension for type*/,
true /*resize*/ ); // and let the rest default
I've never used TCPDF (or PHP for that matter) myself, but according to the docs, some variation on that will work.