<p>Simulation is a valuable technique in training health professionals, but the availability of resources determines which equipment, trainers, and methods to use in each simulation program. Low-income countries face barriers such as a shortage of trained staff and equipment, inadequate infrastructure, and other context-specific challenges in using simulation for training healthcare professionals. This qualitative study, employing semi-structured interviews, aimed to explore medical students’ experiences with learning by simulation in Rwanda, a low-income country. This is among the first studies to explore simulation-based education from student perspectives in Rwanda. Fifteen (<i>n</i> = 15) medical students (male: <i>n</i> = 12; female: <i>n</i> = 3) provided consent to participate in semi-structured interviews. Despite the many challenges faced by medical students as they engaged in simulation-based learning, study participants demonstrated an interest in learning through simulation. They perceived it as essential in acquiring and enhancing procedural skills in a relaxed and no-stakes learning environment. Additionally, learning by simulation methods helps medical students approach patients confidently, especially those with complex and/or less common medical conditions. Study participants identified organizational issues and limited simulation capacity as significant barriers to the effective implementation of simulation-based medical education in Rwanda. They expressed the need to invest more time and resources in simulation for a more impactful simulation-based training program. Integrating standardized simulation into a formal medical curriculum would address most of the organizational issues encountered and lead to a structured and consistent skills training program throughout undergraduate medical training in Rwanda.</p>