OBJECTIVES. To characterize the use of high-fidelity mannequins and standardized patients in US pharmacy colleges and schools. METHODS. A survey instrument was sent to 105 doctor of pharmacy (PharmD) programs to collect data on the use of simulation and to identify barriers to using simulation-based teaching methods. RESULTS. Eighty-eight colleges and schools completed the survey instrument (response rate 84%). Of these, 14 did not use high-fidelity mannequins or standardized patients within the curriculum. Top barriers were logistical constraints and high resource cost. Twenty-three colleges and schools used simulation for introductory pharmacy practice experiences (IPPEs), 34 for interprofessional education, and 68 for evaluation of at least 1 core competency prior to advanced pharmacy practice experiences (APPEs). CONCLUSIONS. Although the majority of US colleges and schools of pharmacy use simulation-based teaching methodologies to some extent in the pharmacy curricula, the role of simulation in IPPEs, interprofessional education, and assessment of competency-based skills could be expanded.