Local region-based active contour models (ACMs) can effectively segment images corrupted by intensity inhomogeneity, however, they always converge to local minimum and are sensitive to the initial position of contour. In this paper, a novel fuzzy ACM is proposed to tackle these problems. In order to deal with intensity inhomogeneity, the fuzzy local fitted image is first defined and utilized for constructing a local-region based fuzzy energy term, which is minimized in a variational level set framework to accurately segment inhomogeneous images. Second, the fractional-order diffusion based edge indicator is used to scale the local fuzzy energy term to reduce the effect of intensity inhomogeneity. Third, the fuzzy signed pressure force (FSPF) function defined by local image information is used for constructing the weighted area term to further improve the accuracy of the developed model. Finally, the global FSPF is formulated and used as an adaptive force, which can drive the level set function (LSF) to adaptively move up or down according to image intensity information. Therefore, the initial contour can be initialized as a constant function, which eliminates the problem caused by contour initialization. Moreover, the global FSPF makes the proposed model not easy to fall into local minimum. The results of experiments on synthetic and real images validate the accuracy of the proposed model for inhomogeneous image segmentation. INDEX TERMS Active contour model, inhomogeneous image segmentation, fuzzy local fitted image, edge indicator, FSPF function.