INTRODUCTION: Realistic simulation is increasingly present in academic curricula. The traditional method of teaching is being gradually replaced by new methodological approaches, which reliably reproduce real situations and produce technical knowledge and skills in medical students in the medical emergency.Realistic simulation is increasingly present in the academic curriculum. The traditional method of teaching is being gradually replaced by new methodological approaches, which reliably reproduce real situations and produce technical knowledge and skills in medical students in the medical emergency. The aim of this study was to carry out a systematic review of articles on realistic simulation as an educational tool in emergency medicine. A systematic review of articles on realistic simulation as an educational tool in emergency medicine, published in the corresponding period from January 1th, 2014 to October 28, 2018, was carried out in the SCOPUS database. The keywords were "simulation training", "medical students" and "emergency medicine". The research strategy resulted in 124 references. After the search for the title and summary of the citations considered for eligibility based on the inclusion criteria of the study, 106 articles were excluded, and 18 articles were retrieved and included in the final sample. The studies were distributed in 5 categories to better systematic review of the organizational quality, they are: Realistic simulation associated with the ultrasonography in the emergency; Realistic simulation and electronic devices; The effectiveness of realistic simulation in resource optimization; Impact of simulated training on student confidence; Realistic simulation as a tool in the development of skills and knowledge. This study presents the main aspects of realistic simulation as an educational tool in emergency medicine. It can be concluded that this new teaching approach has several benefits for students to learn, such as: stimulating students in the learning process, retaining technical skills in procedures, providing a safe environment for users to repeat optimization of time and financial resources.Keywords: realistic simulation, emergency medicine, educational, systematic review