30 orthopaedic trainees were included in this randomized trial investigating the effect of simulation-based training on ankle arthroscopy performance. Following baseline simulation-arthroscopy and cadaveric diagnositc arthroscopy, participants were randomized to either four sessions of ankle arthroscopy simulator training, or to standard arthroscopic exposure. Performance evaluation was based on a 15-point checklist and the Arthroscopic Surgery Skill Evaluation Tool (ASSET) during post-intervention simulator testing and cadaveric arthroscopy. Results demonstrated faster completion of post-intervention arthroscopy on both simulator and cadavers within the Simulation Training group, as well as significantly higher scoring on the ASSET.