Background: Simulation based learning is a highly successful teaching and learning method. However, it is underutilized or ineffectively offered in low and middle income country. There is paucity of evidence on satisfaction related to simulation based learning among level based public health science college students in Ethiopia. Objective: To assess level of satisfaction with simulation based learning and associated factors among level based public health science college students, Amhara, Ethiopia, 2021. Methods: Institution based cross sectional study was employed from September 6th up to October 6th, 2021 in public health science colleges in Amhara region among 422 level based under graduate health science students. The particpants were selected by systematic random sampling technique. Self-administered questionnaire was employed. Data were coded, entered and cleaned using Epi-data version 4.2 package and exported to Social package statistical software version25for analysis. Binary logistic regression analysis was computed to assess satisfaction with simulation based learning and associated factors. Adjusted Odds ratio with its 95% Confidence interval was reported and P- value < 0.05 was considered as statistically significant. Results Proportion of students’ satisfaction with simulation based learning was 188 (45.6%). Students perceived presence of active learning (AOR =2.9, 95% CI=1.69-5.0), collaboration (AOR=2.09, 95% CI=1.17-3.73), objective (AOR=2.25, 95%CI=1.31-3.86) and presence of problem solving (AOR=2.65, 95%CI=1.47-4.76) were significantly associated to satisfaction with simulation based learning. Conclusion and recommendations The overall proportion of satisfaction with simulation based learning was low. Presence of active learning, collaboration, problem solving and clear objective were significantly associated with satisfaction of simulation based learning. The study recommended shall to strengthen simulation based learning practice Key words: Satisfaction, simulation based learning, level based 1. INTRODUCTION