Aim: This research attempted to examine the effects of simulation-based education regarding knowledge and clinical performance ability on Endotracheal suctioning among nursing student. Design: A quasi experimental approach was used. The sample consisted of 12 numbers of nursing students and were selected by purposive sampling method. Results: The mean pre-test scores were 6.17 and 8.08 in the post-test. There was a statistically significant difference between the pre-test and post-test in the study group at p<0.05. The mean pre-test performance ability was 19.50 in the pre-test as compared to 22.58 in the post-test. There was a statistically significant difference between the pre-test and post-test participants performance ability at p<0.05. A significant positive correlation was found between post-test knowledge and performance ability (r = 0.0325). The results revealed that increase in knowledge and skill due to simulation intervention enhanced the performance ability of the students. 100 % indicated that the simulation experience provided active deep learning. Conclusion: Simulation based learning had a positive correlation on knowledge and performance ability regarding endotracheal suctioning.