Background: Simulation linked Problem-based Learning (S-PBL) is a strategy, through which the students learn effectively while introducing students to real-world scenarios and professional nursing procedures. Aim of the study: to evaluate the effect of simulation linked problem based learning strategy on nursing students' performance regarding care of children undergoing open heart surgery. Setting: clinical pediatric laboratory skills, laboratory simulation-based training and teaching hall of Faculty of Nursing/ Benha University. Subjects: A simple random sample was used for the purpose of sample selection. A quasi-experimental research design was utilized Tools of data collection: three tools were utilized; Pediatric Student-Nurses' Knowledge Assessment Sheet, Observation Checklists And Barriers of Using Problem-Based Learning Strategy Questionnaire. Results: Minority (1%) versus most (95%) of the studied students had good total knowledge level pre\post the S-PBL strategy application respectively. Minority (3%) versus most (92%) of the studied students had competent level of practice pre\post the S-PBL strategy application respectively. Minority (4%) versus most (98%) of studied student had positive perspective toward barriers of using PBL strategy pre\post S-PBL strategy application. Conclusion: Students had higher levels of knowledge and practices post strategy application than pre application. Also, the barriers faced by the studied students regarding PBL reduced. Recommendation: the S-PBL strategy application is encouraged to be on larger sample size and on most faculties of nursing in Egypt. Application of PBL strategy needs to be done on a larger sample number