Simulation-based medical education (SBME) is an increasingly essential element of pediatric residency training. It is an effective educational strategy, and its use is rapidly expanding based on advancements in technology as well as a growing need for educational interventions to supplement pediatric clinical training. This chapter will outline the benefits of and challenges to SBME and review key elements and best practices within SBME. It will also provide an overview of current uses of SBME within pediatric residency. Finally, it will review the next steps and future opportunities for the field of SBME within pediatric resident education.