Incorporating high-fidelity simulations into an undergraduate nursing program’s perioperative elective course capitalizes on students’ active learning. Simulations allow students the opportunity to assess and participate in clinical scenarios, apply standards, and demonstrate correct nursing actions without compromising patient safety. Incorporating a high-risk, low-volume malignant hyperthermia simulation experience into the undergraduate nursing curriculum emphasizes active learning and provides an opportunity for students to experience an uncommon emergency perioperative event. A high-fidelity malignant hyperthermia simulation links a scenario with course content, incorporates didactic information from previous courses, and emphasizes the importance of debriefing.