Medical Simulation has become a standard training tool for novice providers and master clinicians alike. In a controlled environment, everything from communication skills to crisis resource management and procedures can be practiced and evaluated. The traditional "see one, do one, teach one" pedagogy is antiquated as high fidelity simulation experiences allow for a safer "see one, practice a few, do one, teach one." This is especially embraced in the pediatric community where our patients are sometimes less cooperative and the stakes can feel emotionally heightened. This handbook represents lessons learned from hundreds and thousands of hours of personal experience with Pediatric Simulation and is appropriately rooted in the best evidence and shared knowledge in simulation literature. This handbook is not meant to be a comprehensive overview of Pediatric Simulation. Those books exist. The journals are great. The communities of Pediatric Simulation experts are welcoming and beyond wonderful. This handbook is meant to be a pragmatic consult. If you are a brand-new simulation faculty member looking for an outline of best practices with practical tips for implementation, this handbook is for you. If you are a seasoned simulation veteran with good working knowledge of simulation wondering how to develop pediatric-specific programs, this handbook is for you. If you are a simulation tech or new operations staff trying to train and orient yourself, this handbook is for you. If you are trying to help make the case for a certain type of simulation program to stakeholders, this handbook is for you. We hope that sharing our personal wins and lessons alongside evidence reads as a consult or a helpful colleague.