Simulation is increasingly used as an educational methodology for teaching empathy to preservice health professional students. This systematic review aimed to determine if and how simulation, including games, simulated patients, and role-play, might develop empathy and empathetic behaviors in learners. Eleven databases or clearing houses including MEDLINE, EMBASE, CINAHL, PsychInfo, and ERIC were searched for all articles published from any date until May 2014, using terms relating to (i) preservice health professional students, (ii) simulation, and (iii) empathy. Twenty-seven studies met the inclusion criteria, including 9 randomized controlled trials. A narrative synthesis suggests that simulation may be an appropriate method to teach empathy to preservice health professional students and identifies the value of the learner taking the role of the patient.