Turbo Pascal generates DOS only executables (and you will need a fix for run-time error bug on fast machines). Indeed, you can try using interrupts to change video mode to 13h (320x200) and then accessing video memory directly (at A000:0000, if my memory is correct), but you may want to explore other options first.

In order to create Win32 console executables (if that's what you are after), you can use either FreePascal or Delphi. Using either OpenGL and Direct3D you can draw images and stuff, but it's no longer made on pixel-by-pixel basis (though it's still possible), though it needs video hardware to do this. There is another option - using DirectDraw. It's rather outdated but if you really need only to manipulate pixels, this option may be worth exploring.