Simulation-based nursing education is an increasingly and wide-spread preferred educational approach. It offers opportunities to acquire clinical skills and decision-making through various situational experiences. Aim: Evaluation of simulation effects on maternity nurses’ knowledge, practice and self-efficacy during management of eclamptic fits. Design: A quasi experimental design was utilized. Setting: The study done in Obstetrics and Gynecology Department of Benha Teaching Hospital. Samples: A convenient samples include 40 nurses. Tools: Data collecting by using 3 tools: A Structured self-administered questionnaire, observational checklists and self-efficacy scale. Results: A highly significant difference among pre-intervention and immediate post-intervention and 8 weeks’ post-intervention regarding knowledge, practices and self-efficacy of nurses concerning management of eclamptic fits. Conclusion: Simulation-based training is effective training approach that enhances maternity nurses’ knowledge, practice and also increases their self-efficacy regarding management of eclamptic fits. Recommendations: All maternity nurses in different settings should attend regular simulation-based and refreshing courses to improve their knowledge, practice and self-efficacy.