Background <p>This simple pulsatile pump model (PPM) provides a realistic and low-cost model for microsurgical training. In this manner, the use of live animals for realistic microsurgical training is reduced, as it is possible to combine our model with several artificial microsurgical training models while retaining pulsatile flow.</p> Method <p>We detail steps for construction of the PPM for realistic microsurgical training under pulsatile flow – as well as microsurgical training examples – in a tried-and-true, cost-effective fashion, from readily available monitoring and infusion materials. The PPM is prepared by assembling a closed-loop system with two pressure applicators (infusion pumps/infusomats), a monitoring set connected to a transducer and display, and various infusion components (two intravenous drip/intrafix sets, saline, three-way stopcocks/discofix C, Heidelberger extension line, and pressure bags), allowing for adjustable pulsation frequency, flow and pressure as well as continuous pressure monitoring. The PPM can be used for a variety of microsurgical tasks, including microvascular repair and anastomosis and aneurysm clipping, providing a realistic and controlled animal-free training environment.</p> Conclusion <p>This model enables near-realistic microsurgical training under adjustable pulsatile flow based on readily available materials.</p>