Objective: Breast cancer is the leading type of cancer in women worldwide and the number of cases is increasing in developing countries. Besides the other imaging diagnostic tools ultrasound guided breast biopsies are being performed for accurate diagnosis. This procedure requires hand-eye coordination skills with two dimensional ultrasound imaging and tracking biopsy needle. Method: Ultrasound biopsy simulator incorporates a cohesive platform between virtual reality, physical objects, location sensors, haptic feedback data and scenarios. A game scoring system was also incorporated into software interface of the simulator. Silicone based breast and thorax model inserted in a torso were used as physical models. Ultrasound probe and biopsy needle were integrated with location sensors and haptic feedback device. A software interface with different training scenarios was developed. Results: Compared with the existing breast biopsy simulation modalities, the main advantages of this simulation system were that the breast lesions of different types could be generated at any quadrant of the breast tissue and the lack of needle tracks originating from the previous procedures. Conclusion: A novel ultrasound based biopsy simulation system was created for breast lesions that may help to improve technical skills of trainees during the learning period of biopsy procedure. By adding other virtual anatomic and physical models, new modules for liver and renal biopsies can be added to the existing platform.