Simulation training encompasses all methods of learning technical skills that do not require practicing on a live patient. Surgical training typically uses an apprenticeship model, in which responsibility is gradually shifted from attending surgeon to the trainee over years of experiences with live patients. Skill acquisition from simulation modalities can prevent unnecessary harm to patients if trainees have practice and experience from simulation before participation in live surgeries. Surgeons are morally required to prevent unnecessary harm to patients, regardless of whether they are consequentialist or nonconsequentialist in one's metaethics. It is the authors' opinion that simulation training is a moral imperative, as there is early empirical evidence for preventing harm to patients and it should be incorporated to the extent it is feasible in every surgical training program. Further definitive studies need to be performed.