Radial artery pulse observation based medical diagnosis evolved during 1500 BC and is still practiced in the modern era. In Traditional Indian Medical Systems (TIMS), such as Ayurveda, Siddha, Unani, etc. radial artery pulse diagnosis using one to three fingers is a widely used technique for disease diagnosis as well as prognosis. By altering the applied finger pressure, physicians try to estimate seven different features of pulse, i.e., average rate, rhythm, shape, volume, arterial wall features, and temperature. The combination of these features helps them identify underlying diseased conditions. Medical students acquire this skill from experts by verbal communication, observation, and personal experience. However, such training is time consuming and highly subjective since it depends on individual’s tactile perception capability and exposure to the subjective variation during the training period. In order to address these shortcomings, since the nineteenth century, training simulators have been used. They were mostly circulatory loops generating pressure waves to simulate pulsatile arterial blood flow. However, over the past decade, no review has been done on the recent developments in this field. This paper presents a systematic literature review of existing simulators categorizing them based on (1) force transfer mechanism, (2) force generation mechanism, (3) sensory modalities involved, and (4) fidelity level. Merits and demerits of different mechanisms used in these systems are further discussed which leads to identification of research gaps. In addition to addressing various design challenges, this paper also delineates a few key requirements for an improved pulse simulator design and development.