There are provided an X-ray CT scan simulator and an X-ray CT apparatus in which a lesion postulated by an operator can be displayed on a simulation image and a high-precision simulation containing a postulation of occurrence of a new lesion can be performed. They comprise an image storing device for storing a reference image, a target noise value setting device for setting a target noise value of a desired image, a simulated lesion setting device for setting a condition for a simulated lesion postulated by the operator, a simulation image generating device for generating a simulation image containing a simulated lesion by using the reference image on the basis of the set target noise value and the condition for the simulated lesion, and an image display device for displaying the simulation image containing the simulated lesion.