INTRODUCTION: Simulation is a method of learning in which the learner experiences a simulated situation instead of being physically present. Exposing students to simulation based education improves learners’ clinical competence and ability to make decisions which are crucial for today’s health workforce. Even though there are limited studies conducted to assess Midwifery students’ satisfaction in simulation based education in Ethiopia; there are gaps in determining the factors related to their learning environment and design characteristics. OBJECTIVE: This study aimed to assess students’ satisfaction and associated factors of simulation based education among Midwifery students of governmental Universities in Amhara region, Ethiopia, 2022. METHODS: Institution based cross-sectional study was conducted on 413 students at Amhara region Universities from August 1- 30, 2022. Data were collected from third and fourth year regular undergraduate Midwifery students through self-administered questionnaire using a simple random sampling technique. Epi Data version 4.6 and Statistical Package for Social Sciences version 26 were used for data entry and analysis respectively. Bivariable and multivariable logistic regression analysis were employed; a P-value of less than 0.05 was considered statistically significant in the study. RESULTS: This study revealed that 84.7% (95% CI; 81.1-88.3) of Midwifery Students in Amhara region Universities were satisfied with Simulation based education. Year of study [AOR: 2.936; 95% CI (1.531-5.631)]; Adequate support [AOR: 2.903; 95% CI (1.217-6.922)]; Availability of instructors (AOR=2.861, 95%t CI (1.078-7.591) and Provision of checklists [AOR: 2.326; 95% CI (1.143-4.734)] were found to be statically significant variables. CONCLUSION AND RECOMMENDATION: The results of this study revealed higher satisfaction of undergraduate Midwifery students towards simulation based education as compared to previous studies conducted in Ethiopia. Predictor variables such as year of study, support, instructor’s availability and provision of checklists had a significant association with students’ satisfaction. Therefore, Midwifery departments should strengthen the support given by staff; encouraging their instructors to be available during simulations and also improve the utilization and provision of checklists to students as much as possible. KEY WORDS: Satisfaction, Simulation Based Education, Amhara Region