Background Simulation-based nursing training helps students develop skills, such as critical thinking, decision making, and the ability to manage cases. Method A two-group, nonrandomized, and quasi-experimental study examined the effect of using classical and simulation-based pediatric nursing training on students’ perception of self-efficacy and anxiety levels as measured by the State–Trait Anxiety Scale. Cognitive learning and social learning theories guided our study. Participants were third-year undergraduate nursing students taking a pediatric nursing course from the same instructor during two different academic years in Turkey. The control group included 115 students selected from the spring term of the 2013 to 2014 education year, and the experimental group included 112 students selected from the spring term of the 2014 to 2015 education year. Results The simulation-based nursing training group's perception of self-efficacy was significantly higher in pediatric assessment, taking anthropometric measurements and vital signs, some medication administration, and care activities (p <.05). This study found no difference between the groups in the state anxiety mean scores of the students. The simulation-based nursing training group's trait anxiety mean scores were significantly lower (p <.05). Conclusion Simulation-based nursing training enhances pediatric nursing students’ perception of self-efficacy about their practice skills while reducing their anxiety level.