Background <p>Simulation-based learning (SBL) is a structured educational method that enables learners to practice clinical, technical, and decision-making skills in a safe, immersive, and controlled environment. It has become a cornerstone of modern medical education.</p> Objective <p>This study aimed to assess the effect of SBL on the academic performance of medical students at the pediatrics end of the clerkship examination.</p> Methods <p>We analyzed the academic performance of 2,251 fifth-year medical students over 12 academic years, from September 2012 to June 2024, at the end of the pediatric clerkship. The period includes six years before and six years after the integration of simulation-based learning into the pediatric curriculum. </p> Results <p>The performance of the students in the three components of the end of the clerkship examination, written, clinical, and continuous assessment, after the utilization of SBL was much better than their performance in the era before the SBL. The difference was statistically significant (p &lt; 0.001).</p> Conclusion <p>The study highlights the positive impact of incorporating SBL into pediatric education for medical students in Bahrain. These findings support the wider integration of simulation as a teaching strategy across various clinical specialties in medicine and other sciences worldwide. They also highlight its potential to progressively complement and, in some cases, partially replace traditional classroom-based instruction.</p>