Complex surgical technologies, restricted resident work hours, and limited case volumes in surgical practice have created new challenges to surgical education. At the same time, maintenance of established skills and development of new skills are becoming increasingly important for surgeons, especially skills related to technically challenging minimally invasive surgical therapies. In addition, minimally invasive therapies are highly dependent on uniquely specialized teams of health care workers. For all of these reasons, simulation is gaining attention in surgical education for the development and refinement of minimally invasive surgical skills and technique. This article summarizes developments and challenges related to simulation in surgical education, especially as it relates to minimally invasive surgical therapies in the field of urology.