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Abstract:Introduction: Cesarean delivery is the most common surgical procedure in obstetrics, yet preclinical medical students have limited exposure. Procedural unfamiliarity may contribute to anxiety and decreased confidence during clerkships. Simulation-based education provides a low-risk environment to build foundational knowledge and comfort before direct patient care. We evaluated whether a combined didactic and simulation-based c-section curriculum improves procedural comfort and objective knowledge among preclinical students.Methods: Students participated in a structured curriculum consisting of a focused didactic lecture followed by hands-on simulation using a low-cost, high-fidelity c-section model. Participants completed matched pre-/post-intervention surveys assessing comfort across five cesarean-related domains using a 5-point Likert scale. Objective knowledge was measured using an ACOG-based c-section quiz. Learner expectations and satisfaction were also assessed. Paired t-tests were used to compare pre-/post-intervention outcomes. Results: Baseline comfort was low across all domains (mean 1.04–1.78), reflecting minimal operative exposure. After the intervention, comfort significantly improved in surgical instrument familiarity, identification of anatomical layers, participation in cesarean delivery, suture selection, and understanding of indications (post-intervention means 2.68–3.86; all p< 0.001). Objective knowledge scores increased from 0.36±0.17 to 0.79±0.13 (p< 0.001). Satisfaction exceeded expectations, increasing from 3.59±1.10 to 4.82±0.39 (p< 0.001).Conclusion: A combined didactic and simulation-based c-section curriculum significantly improves both knowledge and procedural comfort among preclinical learners. Early exposure to operative obstetrics may ease transition into clerkships and enhance readiness for clinical participation. Simulation-based surgical education represents an effective strategy to strengthen foundational obstetric training and may improve engagement in obstetrics and gynecology. Keywords: Cesarean Section, Obstetric Simulation, Obstetrics and Gynecology, Preclinical Medical Student Education, Simulation-Based Medical Education, Skills-Based Learning, Procedural Competency, Experiential Learning, Likert Scale Analysis, Pretest-Posttest Design