Purpose: This study is a meta-analysis to assess the effect of simulation-based learning using virtual reality (VR) on knowledge, affective, and performance domain outcomes of learning in nursing students. Results:A total of 10 studies (5 randomized control trials (RCTs) and 5 non-RCTs) involved 630 nursing students. As a whole, simulation-based learning using VR appeared to have beneficial effects on the knowledge (I 2 =50%, 95% CI 0.35 [0.09, 0.62], P=0.009), have no significant difference on the performance (I 2 =97%, 95% CI 1.05 [-0.54, 2.63], P=0.19) and have a negative impact on the affective field (I 2 =0%, 95% CI -0.43 [-0.71, -0.15], P=0.003). Conclusion:The existing evidences imply that simulation-based learning using VR might have a positive trend that is beneficial to knowledge and clinical skill acquisition. However, the best way of integration still needs further research to be identified.