Recent changes to the working practices of physicians in both Europe and the United States have led to concerns regarding a reduced exposure of surgical trainees to operations and thus a potential for a decreased operative experience throughout training. Simulation has been used in many professional fields such as the aeronautical industry to prepare pilots prior to real-life situations and has become recognised as a potentially useful educational tool in surgery. Surgical skills from basic knot-tying to more sophisticated simulation programmes for aortic aneurysm surgery have been introduced in surgical training programmes. Surgical simulation has been demonstrated to have validity in preparing surgeons for operative situations; however, a commitment from educators, protected time and well-orchestrated sessions are key elements in the success of a simulation programme. This article provides 12 tips for the development and implementation of an effective surgical simulation programme informed by experience of large-scale simulation at an academic institution and relevant literature regarding simulation training.