Significant progress has been made in the study of optical coherence tomography (OCT) — a non-invasive, high resolution, and in vivo diagnostic method for medical imaging applications. In this paper, the principles of noise analyses for OCT systems have been described. Comparisons are made of signal-to-noise ratios for both balanced and unbalanced detection schemes under the ideal no-stray light situation as well as the non-ideal situation where residual reflections and scatterings are presented. Numerical examples of noise calculation accompanied by detailed comparison of the main characteristics of both time-domain and frequency-domain OCT systems are also presented. It is shown that a larger dynamic range can be achieved for a Fourier-domain OCT system even under the circumstances of high-speed image acquisition. The main results presented in this paper should be useful for the development of high performance OCT systems.