Objective: to assess the effect of a simulation -based training program (PROMPT) on the mode of delivery of breech presentation and to evaluate the neonatal outcomes. Design: a retrospective cohort study Setting: Rafic Hariri University Hospital (RHUH), a tertiary center in Beirut, Lebanon Population: A total of 92 pregnant women delivering a singleton with a breech presentation between June 2018 and December 2019 Methods: We used data from the local perinatal registry at the RHUH. Clinical outcomes were analyzed according to whether the obstetrician attended the “Train The Trainer” course of the PROMPT or not. Main outcome measures: Clinical measures include: the prevalence of cesarean deliveries in the groups R6 and R7 according to the Robson’s classification and neonatal outcomes (Apgar score at 1 and 5 minutes and admission to the neonatal intensive care unit (NICU) Results: The prevalence to deliver a breech presentation by assisted vaginal delivery is increased in group R6 of Robson’s classification and not in group R7 after the simulation and the retention of skills is time-related. No adverse neonatal outcomes were noted in both groups. Conclusion: The simulation-based course improved the management of assisted vaginal delivery in breech presentation mainly in group R6 of Robson classification, without increasing neonatal complications and the retention of skills decreases over time. Keywords: simulation, breech delivery, Robson classification, PROMPT