Traditionally, the training of emergency physicians relies largely on dealing with real clinical problems and learning through experiences. Our residents accumulate a lot of experiences and knowledge; however, for the instructor, it might be difficult to find the balance between patient safety and adequate training. Disaster medicine and training for uncommon cases also gained attention. These events happen very rarely, might not even be encountered during training, but once it happens, rapid and correct management is critical. In the past, we used classroom sharing, tabletop exercise, and drills for training. Yet, trainees often complained that these programs lacked sense of reality. Recently, with the aid of high-fidelity medical simulator, we provided training programs to improve the ability of emergency department team to manage critical diseases and special conditions. We also held workshop to promote the efficiency of inter-department cooperation. This article describes our experience of medial simulation in emergency medicine and its applications in disaster medicine.