A Monte Carlo (MC) method for modeling optical coherence tomography (OCT) measurements of a diffusely reflecting discontinuity emb edded in a scattering medium is presented. For the first time to the authors' knowledge it is shown analytically that the applicability of an MC approach to this optical geometry is firmly justified, because, as we show, in the conjugate image plane the field reflected from the sample is delta-correlated from which it follows that the heterodyne signal is calculated from the intensity distribution only. This is not a trivial result because, in general, the light from the sample will have a finite spatial coherence that cannot be accounted for by MC simulation. To estimate this intensity distribution adequately we have developed a novel method for modeling a focused Gaussian beam in MC simulation. This approach is valid for a softly as well as for a strongly focused beam, and it is shown that in free space the full three-dimensional intensity distribution of a Gaussian beam is obtained. The OCT signal and the intensity distribution in a scattering medium have been obtained for several geometries with the suggested MC method; when this model and a recently published analytical model based on the extended Huygens-Fresnel principle are compared, excellent agreement is found. (C) 2002 Optical Society of America.