Conventional medical equipment used for treating patients with ischemic heart disease relies on pneumatic compression to achieve intense and instantaneous compression of the legs. Because the pneumatic operation of a compressor inevitably produces noise, the treatment is given to a patient in a separate room to avoid causing discomfort to other patients. This need for a dedicated treatment room could be another source of increased medical costs. In this study, a new electrical motor-driven system was developed to address the noise problem of existing pneumatic compression devices. Additionally, the new system features a reduced footprint and weight, and can be carried by medical staff. To develop a low-noise leg compression machine, the noise level at the surface of the structure was estimated using multibody dynamics simulation. Based on the initial design of the electric leg compression machine, parameters including assembly tolerance, component material, and shape of the structure were adjusted to prepare variations of the initial design, and their noise characteristics were analyzed. It was found that by applying the design variables, the noise levels were reduced by 7.2–11.7% compared with the initial design. The most significant reduction in noise levels was 11.7% and was achieved by reinforcing the section surrounding the gearbox enclosing a noise source.