Background: Pediatric cochlear implantation improves the quality of life for hearing-impaired children by enhancing communication. Simulation-based education links classroom learning to real-world practice, enabling nurses to provide high-quality care for children with cochlear implants. This study aimed to evaluate the impact of simulation-guided training lines on nurses' performance caring for children with cochlear implantation. Methods: A quasi-experimental research design was used (pre/post & follow-up). Setting: The study was conducted in the Ear, Nose, and Throat inpatient and outpatient clinics at Sohag University Hospital were selected from October, 2023 to March, 2024. Subjects: A convenient sample composed of all 50 nurses who are working in the previously mentioned settings. Tools for data collection: (1) a structured interview questionnaire sheet and (2) An observational checklist was utilized to assess nurses' practice and collect data. Results: Regarding knowledge and practice, there was a very statistically significant difference among the nurses (P<0.001). The study's findings showed that, before the implementation of the simulation-guided training lines, two-thirds of the nurses were poorly informed about cochlear implantation, and more than half of them had incompetent levels of practice in this area. Following the implementation of simulation-guided training lines, the vast majority of the examined nurses had a good level of knowledge, and the majority of them had a competent level of practice. When compared to pre-simulation guided by training lines, nurses' performance showed a very statistically significant difference and improvement (P ≤ 0.001). Conclusion: Simulation guided by training lines had a positive impact on nurses' knowledge and practice with cochlear implant surgery. Recommendations: Incorporating simulation-based training for nursing staff across diverse specialties can significantly enhance their knowledge and competence in cochlear implantation, ultimately leading to improved patient care and outcomes.