The exercise was aimed at testing warning systems and preparedness in nations in Asia, Australasia, the Middle East and Africa.
Hundreds of people including school children ran from the coast in the Indonesian province of Aceh, the area worst hit by the 2004 tsunami, with 168,000 killed.
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Red Cross volunteers, police and soldiers helped people smeared with mud and fake blood into ambulances which carried them away from the coastline.
But for many, the drill only served to revive horrific memories of the real thing.
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"This sort of exercise is useful for letting me know if a tsunami strikes. But the sirens and crowds make me panic, they remind me of the 2004 tsunami," said Bachtiar, a resident of the Acehnese town of Ulee Lheue.
Another resident, 20-year-old R