Background and Objectives: This study aims to investigate the relationship of communication skills with clinical self-efficacy and clinical competence in operating room students. Methods: This is a descriptive-correlational study. Participants were 100 operating room students from the School of Allied Medical Sciences, Qom University of Medical Sciences, Qom, Iran in 2021, who were selected by a census method. To collect data, in addition to a demographic form (surveying age, sex, semester), Queendom communication skills test, perceived perioperative competence scale-revised, and clinical self-efficacy questionnaire were used. Descriptive statistics (Percentage, Mean±SD) and inferential statistics (Pearson correlation test, independent t-test, and ANOVA) were used in analyzing the data. Results: There was a significant and positive correlation between communication skills and clinical competence (r=0.478, P≤0.001) and between communication skills and clinical self-efficacy (r=0.445, P≤0.001). Conclusion: Communication skills of Iranian operating room students have a positive and significant relationship with their clinical self-efficacy and clinical competence. Considering the importance of communication skills in providing safe and high-quality patient care, attention should be given to the communication skills training of these students by the educational planners and managers.