Speckle noise and intensity inhomogeneity are always challenging issues in the area of image segmentation, especially when both difficulties appear simultaneously. Consequently, the majority of existing deformable models yield inadequate results in this situation. This paper aims to address these issues by combining a bias correction term and a despeckling term into a single variational level set architecture, which not only corrects the severe intensity inhomogeneity but also performs image despeckling and segmentation simultaneously. Specifically, edge and region synergetic terms are defined to correct the severe intensity inhomogeneity during image segmentation that eradicates their shortcomings as well as retains their advantages. Further, a despeckling term is constructed, which effectively suppresses the noise while enhancing image details. Since the lack of thorough investigation on despeckling of images degraded by Rayleigh noise distribution, which usually appear in ultrasound (US) images, so we included it in the coupled deformable model (CDM). Moreover, region-based terms eradicate complex re-initialization and numerical instability during the level set evolution, as a result, no distance regularization term is needed. Additionally, Schauder’s fixed point theorem is used to demonstrate the well-posedness of the present system. Extensive numerical experiments on real and synthetic images with speckle noise and severe inhomogeneous intensity demonstrate that the CDM exhibits superior results compared to classical and some recent deformable models in terms of accuracy, robustness, and various quality measures.