HEALTH CARE PROFESSIONALS are expected to make prompt, accurate decisions in life-threatening emergency situations in the OR.PERIOPERATIVE LEADERS are faced with the challenge of ensuring that OR team members are prepared to respond to potentially lethal emergencies, including rare and infrequent events.THIS ARTICLE DESCRIBES the importance of team training for all members of the OR team. The use of simulation is discussed as a tool to accomplish this goal. Steps for developing a simulation scenario are presented. AORN J 87 (April 2008) 772–779. © AORN, Inc, 2008.