Background: Simulation is an all-inclusive term about incorporating an educational approach that links a learner to a situated environment for the purpose of learning. The efficacy of simulation in undergraduate medical education is now well established as it reduces the number of safety concerns in managing the patients. It helps learners to try out and acquire new knowledge and confidence for effective management of patients. The study was done to analyse the effectiveness of high-fidelity simulation (HFS) based education in enhancement of knowledge and performance for management of acute trauma in terms of self-assessment scores. Methods: It was a pre-test and post-test mediated quasi-experimental time series study which involved 347 undergraduate medical students. During simulation sessions, students were divided into groups and their acquisition of knowledge and performance were evaluated individually with self-assessed pre-test and post-test scores. Mean, Standard Deviation and Standard Error of Mean were used for quantitative analysis and Repeated Measure of Analysis of Variance (ANOVA) was used for comparison. Friedman test was used for assessment of individual components in simulation. The scores were compared to note the difference in knowledge and performance. P value < 0.001 was considered to be statistically significant. Results: The study showed that learning and performance had progressively improved with each session of simulation in the management of acute trauma. Conclusion: Students’ self-assessment showed that HFS based education had made a difference with enhancement of knowledge and performance over time in the management of acute trauma.