In this paper we report on a general methodology to investigate nanowire MOSFETs based on the coupling of mechanical simulation with 3-D real-space Monte Carlo simulation. The Monte Carlo transport model accounts for both strain silicon and quantum mechanical effects. Mechanical strain effects are accounted for through an appropriate change of the anisotropic band structure computed with the empirical pseudopotential method. Quantum effects are instead included by means of a quantum mechanical correction of the potential coming from the self-consistent solution of the Schrodinger equation. This methodology has been then applied to the simulation of a test case silicon nanowire n-MOSFET. Impact of mechanical strain and quantum effects on the drive current is investigated. It is shown that only the inclusion of strain and quantum mechanical effects allows a good agreement with experimental data, demonstrating the validity of the proposed methodology for ultimate devices.