This systematic review sought to highlight the evidence supporting the real-world utility endourological training outside of the clinical environment, the degree of uptake in urology training programs, and the barriers that have prevented simulation and curricular training difficult to incorporate into postgraduate medical education. We felt that by focusing on the educational literature that has demonstrated real-world clinical benefit to participants, we may increase the appeal of incorporating such training methods into existing endourology curricula. We feel it is logical that utilizing educational interventions with evidence supporting their ability to improve the technical ability of trainees in the clinical world will yield the highest educational value.