Reliable detection of the media-adventitia border (MAB) and the lumen-intima border (LIB) in intravascular ultrasound (IVUS) images remains a challenging task that is of high clinical interest. In this paper, we propose a superpixel-wise fuzzy clustering technique modified by edges, followed by level set evolution (SFCME-LSE), for automatic border extraction in 40 MHz IVUS images. The contributions are three-fold. First, the usage of superpixels suppresses the influence of speckle noise in ultrasound images on the clustering results. Second, we propose a region of interest (ROI) assignment scheme to prevent the segmentation from being distracted by pathological structures and artifacts. Finally, the contour is converged towards the target boundary through LSE with an appropriately improved edge indicator. Quantitative evaluations on two IVUS datasets by the Jaccard measure (JM), the percentage of area difference (PAD), and the Hausdorff distance (HD) demonstrate the effectiveness of the proposed SFCME-LSE method. SFCME-LSE achieves the minimal HD of 1.20 ± 0.66 mm and 1.18 ± 0.70 mm for the MAB and LIB, respectively, among several state-of-the-art methods on a publicly available dataset.