The primary emphasis of these packages is on artistic, synthetic terrain, although most of them have at least some limited ability to import real-world data layers.

primarily
meant for creating abstract, arty landscapes
FreeWorld3D
Gscape
Real-time Procedural World Editor
L3DT
by Aaron Torpy
consists
of two Windows applications:
Generator
($200/$100 academic) and
Viewer
(free), from Pandromeda, Inc.
TechNature
currently
free, with beautiful clouds
(2D layers) and excellent sunsets


World
Machine
WorldForge