The design of the extrusion die significantly affects both the extrusion process and the quality of multi-lumen tubes. Traditional design methods that rely on trial and error tend to increase manufacturing time and costs while diminishing product quality. This study utilizes inverse extrusion simulation and optimization to design the extrusion die without the need for trial and error. The inverse extrusion simulation generates the die profile necessary to achieve the desired extrudate shape. Subsequently, direct extrusion simulations are conducted to predict the extrudate profile based on the derived die. The optimal volumetric flow rates of air within the lumens are also identified to ensure the extrudate meets the target profile. The results from the direct extrusion simulation, combined with optimization, confirm that the designed extrusion die can successfully produce the target profile. Using the derived die, the multi-lumen tube with the desired specifications is successfully extruded. This design and manufacturing approach enhances both the quality and productivity of multi-lumen tubes.