Optical coherence tomography (OCT) oximetry explores the possibility to measure retinal hemoglobin oxygen saturation level (sO2). We investigated the accuracy of OCT retinal oximetry using Monte Carlo simulation in a commonly used four-layer retinal model. After we determined the appropriate number of simulated photon packets, we studied the effects of blood vessel diameter, signal sampling position, physiological sO2 level, and the blood packing factor on the accuracy of sO2 estimation in OCT retinal oximetry. The simulation results showed that a packing factor between 0.2 and 0.4 yields a reasonably accurate estimation of sO2 within a 5% error tolerance, which is independent of vessel diameter and sampling position, when visible-light illumination is used in OCT. We further explored the optimal optical spectral range for OCT retinal oximetry. The simulation results suggest that visible spectral range around 560 nm is better suited than near-infrared spectral range around 800 nm for OCT oximetry to warrant accurate measurements.