Simulation training in obstetrics and gynecology has been used for hundreds of years. The apprenticeship model of training has evolved to include group simulations and virtual reality trainers. The American Congress of Obstetricians and Gynecologists (ACOG) and other professional societies have recognized the importance of simulation and formulated recommendations and/or curricula for appropriate training of residents, fellows, students, and staff. Obstetrics has utilized simulation mannequins to teach the birthing process and is taking advantage of simulation and the associated debriefing sessions for training in emergency and uncommon scenarios as well as in multidisciplinary training. Gynecology has used box trainers and virtual reality simulation to improve procedural skills of trainees outside the operating room using proficiency-based training paradigms. Simulation has also allowed for improvements in the objectivity of assessments. Future directions may include crowdsourcing for the evaluation of surgical proficiency and possibly for credentialing purposes.