Providers and educators increasingly participate in global health work during their careers. Simulation can play an important role in both preparing learners for work in resource-limited settings and training providers in these countries. However, little guidance exists for educators interested in creating and implementing scenarios for these settings. We discuss several key considerations unique to global health simulation ranging from addressing common cultural differences surrounding healthcare and varied regional approaches to disease identification and management to understanding precisely what resources exist in the setting and what strategies can be used to provide care when the expected resources are not available. We also discuss specific strategies for considering sustainability and for facilitating scenarios in these settings. We developed our recommendations on the basis of existing literature and our own work designing and implementing simulation curricula in resource-limited countries and preparing providers for work in these settings.