Background: The opportunity for students to deliver care safely in today's, complex health care environment is limited. Simulation allows students to practice skills in a safe environment. Purpose: to assess the students' perception, satisfaction, and learning outcomes after a simulation based maternity course. Method: a quasi experimental design was used. A total of 66 nursing students enrolled in the maternity course, academic year 2012-2013. Using a high fidelity simulation, procedure was developed to teach student basic maternity skills. The simulation sessions were conducted during the first 3 weeks of each semester. Two questionnaires were used. The first consisted of 4 parts (1) demographic data, (2) Likert scale to assess the student's satisfaction, (3) Likert scale to assess the outcome, and (4) open ended questions to assess student's perception of simulation. The validity and reliability of the tools were ensured. The second was a Likert scale to assess the students' perception of preclinical simulation sessions. Results: Participants expressed positive perception toward simulation sessions. They agreed that the objectives of the simulation were clear (m = 4.14, + 0.59, and it was appropriate to their level (m = 4.09, + 0.79. Students were satisfied with simulation sessions. They agreed that Simulation assisted in understanding how the clinical practice will be (m = 4.04, SD = 0.93) and it was helpful and effective (m = 3.88, + 1.25). Strengths of simulation reported by students were grouped in four strengths: offered opportunity to practice activities that we are not allowed to practice in clinical sittings, learn from mistakes, enhanced critical-thinking, and immediate feedback. The weakness of simulation was grouped in two main categories: Simulation is not real and has limited human interaction. Conclusion: The results provided evidence that using simulation in maternity course before clinical placement was feasible and beneficial.