The speckle pattern of an optical coherence tomography (OCT) image carries potentially useful sample information that may assist in tissue characterization. Recent biomedical results in vivo indicate that the distribution of signal intensities within an OCT tissue image is well described by a log-normal-like (Gamma) function. To fully understand and exploit this finding, an OCT Monte Carlo model that accounts for speckle effects was developed. The resultant Monte Carlo speckle statistics predictions agree well with experimental OCT results from a series of control phantoms with variable scattering properties; the Gamma distribution provides a good fit to the theoretical and experimental results. The ability to quantify subresolution tissue features via OCT speckle analysis may prove useful in diagnostic photomedicine.