Compared to the nursing and medical professions, simulation-based pharmacy education is a relatively new mode of supporting learning, although one that is growing rapidly to meet the training needs of a new generation of healthcare professionals. Within the UK (and particularly Scotland), access to the clinical environment through the more traditional route of placement is limited, and simulation offers a partial solution to this problem. As is well-established, simulation—if used appropriately—also offers excellent opportunities for enhancing patient safety, including allowing the exploration of the science of human factors. Given the high incidence of medication errors, pharmacists need to be included in any intervention for improvement of patient safety. It is true, however, that the “clinical environment” experienced by the practising pharmacist (especially in community pharmacy) is different from the typical nursing or medical situation. This, combined with a lack of understanding of the role of the pharmacist as a member of the wider healthcare team, means that there are additional considerations required when designing simulation-based learning activities. This commentary undertakes a narrative review of the current situation for pharmacy simulation, and considers how this may be developed to support the Scottish healthcare vision, whilst recognising that the issues raised are likely to be relevant across the sector.