As the malpractice crisis in Obstetrics continues to spiral, safety initiatives within Obstetrics have grown to include simulation as a primary risk reduction strategy. Starting a simulation program requires careful planning and the commitment of all nursing and physician providers to promote a culture of patient safety. This article discusses eight recommended steps towards implementing a simulation program and illustrates through a case scenario how the process of building such a program will be integral to both its success and the fulfillment of your department's goals of providing excellent patient care.