Background: Simulation is defined as "the processes by which we are trying to achieve results approximating clinical practice as closely as possible". It is a technique for replacing or completing real-life experiences with guided experiences, Objective: To assess and explore clinical simulation practice and associated factors among nurse and midwife educators working at teaching institutions in Bahir Dar, Ethiopia. Method: An institutional mixed-method study was conducted from May 9 to June 7, 2022 at six teaching institutions in Bahir Dar City. A sample size of 220 was taken into account for the qualitative study, and a self-administered questionnaire was used to gather data. In-depth interviews were used to acquire data for the qualitative study, which involved eight people. The data was entered into EpiData and exported to SPSS version 26 for additional analysis after being reviewed for consistency and completeness.To evaluate the relationship between the dependent and independent variables, binary logistic regression analyses with both (bi-variant) and (multivariable) inputs were carried out. Result: Among 212 respondents, 104 (49.1%) were government employees. Most of the respondents in this study were male (65.6%). Statistically significant associations between simulation practice experience (AOR= 0.21; 95% CI: 0.07-64), training (AOR =0.52; (95% CI) = (0.27-.98), educational qualification (AOR=0.37; (95% CI) = 0.15-0.93) and cost (AOR = 0.37 ; (95% CI) = (0.18-0.74) The study showed that only 121(57%) of the respondents’ practices were classified as "good practice," while 91 (42.9%) were classified as "poor practice." Qualitative findings revealed that a lack of classroom space, inadequate training in the institution, and a consistent checklist hampered the implementation of clinical simulation practice. Conclusion and recommendation: We determined that a shortage of classroom space, inadequate resources, high costs, and an absence of ongoing training were the key obstacles to the successful implementation of clinical simulation practice. Responsible governmental bodies should give attention for clinical simulation education, Keywords: Practice, Competency, Associated factor, Bahir Dar, Ethiopia