Abstract: The ultrasound simulation for carotid arteries is helpful to the performance assessment of vessel wall detection and signal processing method by using ultrasound techniques. A method for ultrasound simulation of carotid artery wall with a 3-membrane structure is proposed in this paper. According to the ultrasound speckle distributions varying with the shapes and densities of scatterer distributions, as well as the statistic results of the clinical images, the parameters of distributions, densities and intensities of scatterers for different kinds of tissues in the carotid artery phantoms are determined. Each region is acoustically characterized using FIELD II software to produce the radio frequency echo signals, from which ultrasound images are derived. The results based on 30 simulations show that the echo distributions of the intimae, mediae, adventitias and blood are consistent with the clinical ones. Moreover, compared with the results from the central frequency of 8 MHz, the mean measurements of thicknesses of the intima, media and adventitia membranes, as well as the lumen diameter from the simulation images based on 12 MHz are as the same as the preset ones, and the maximum relative errors are the 4.01%, 1.25%, 0.04% and 0.15%, respectively. The simulation under this condition is more realistic.