<p>Our experience of running a simulation centre reveals specific areas of risk that are not widely discussed in the simulation literature- namely the potential for physical harm and threats to the viability and continuity of simulation programmes. Physical harm can occur in unanticipated ways and therefore it is imperative that simulationists acknowledge these risks, and mitigate against them, through robust risk management processes. Key operational risks to the viability and continuity of programmes are financial and human resources. The design and delivery of simulation activities requires a team of individuals who complement each other in terms of administrative, simulation and clinical expertise. There is also a need to ensure that the loss of a key member of the team does not threaten the continuity of the delivery of the simulation programmes. Simulation based education (SBE) is an effective approach to the education and training of healthcare providers. However, it is vitally important to be aware of and manage the safety risks of the activities and ensure human resources are available to ensure the viability and continuity of a simulation facility and programmes.</p>