We have evaluated a method for synthesizing mammograms by comparing the texture of clinical and synthetic mammograms. The synthesis algorithm is based upon simulations of breast tissue and the mammographic imaging process. Mammogram texture was synthesized by projections of simulated adipose tissue compartments. It was hypothesized that the synthetic and clinical texture have similar properties, assuming that the mammogram texture reflects the 3D tissue distribution. The size of the projected compartments was computed by mathematical morphology. The texture energy and fractal dimension were also computed and analyzed in terms of the distribution of texture features within four different tissue regions in clinical and synthetic mammograms. Comparison of the cumulative distributions of the mean features computed from 95 mammograms showed that the synthetic images simulate the mean features of the texture of clinical mammograms. Correlation of clinical and synthetic texture feature histograms, averaged over all images, showed that the synthetic images can simulate the range of features seen over a large group of mammograms. The best agreement with clinical texture was achieved for simulated compartments with radii of 4–13.3 mm in predominantly adipose tissue regions, and radii of 2.7–5.33 and 1.3–2.7 mm in retroareolar and dense fibroglandular tissue regions, respectively.