Existing deep learning real denoising methods require a large amount of noisy-clean image pairs for supervision. Nonetheless, capturing a real noisy-clean dataset is an unacceptable expensive and cumbersome procedure. To alleviate this problem, this work investigates how to generate realistic noisy images. Firstly, we formulate a simple yet reasonable noise model that treats each real noisy pixel as a random variable. This model splits the noisy image generation problem into two sub-problems: image domain alignment and noise domain alignment. Subsequently, we propose a novel framework, namely Pixel-level Noise-aware Generative Adversarial Network (PNGAN). PNGAN employs a pre-trained real denoiser to map the fake and real noisy images into a nearly noise-free solution space to perform image domain alignment. Simultaneously, PNGAN establishes a pixel-level adversarial training to conduct noise domain alignment. Additionally, for better noise fitting, we present an efficient architecture Simple Multi-scale Network (SMNet) as the generator. Qualitative validation shows that noise generated by PNGAN is highly similar to real noise in terms of intensity and distribution. Quantitative experiments demonstrate that a series of denoisers trained with the generated noisy images achieve state-of-the-art (SOTA) results on four real denoising benchmarks.