We create realistic, full-sky, half-arcminute resolution simulations of the microwave sky matched to the most recent astrophysical observations. The primary purpose of these simulations is to test the data reduction pipeline for the Atacama Cosmology Telescope (ACT) experiment; however, we have widened the frequency coverage beyond the ACT bands to make these simulations applicable to other microwave background experiments. Some of the novel features of these simulations are that the radio and infrared galaxy populations are correlated with the galaxy cluster populations, the CMB is lensed by the dark matter structure in the simulation via a ray-tracing code, the contribution to the thermal and kinetic Sunyaev-Zeldovich (SZ) signals from galaxy clusters, groups, and the IGM has been included, and the gas prescription to model the SZ signals matches the most recent X-ray observations. Regarding the contamination of cluster SZ flux by radio galaxies, we find for 148 GHz (90 GHz) only 3% (4%) of halos have their SZ decrements contaminated at a level of 20% or more. We find the contamination levels higher for infrared galaxies. However, at 90 GHz, less than 20% of clusters with M_{200} > 2.5 x 10^{14} Msun and z<1.2 have their SZ decrements filled in at a level of 20% or more. At 148 GHz, less than 20% of clusters with M_{200} > 2.5 x 10^{14} Msun and z<0.8 have their SZ decrements filled in at a level of 50% or larger. Our models also suggest that a population of very high flux infrared galaxies, which are likely lensed sources, contribute most to the SZ contamination of very massive clusters at 90 and 148 GHz. These simulations are publicly available and should serve as a useful tool for microwave surveys to cross-check SZ cluster detection, power spectrum, and cross-correlation analyses.