The purpose was to compare resident endovascular simulator performance with and without prior simulation.Radiology residents were guided through a practice simulation and lectured on endovascular therapy, then randomized to simulate femoral arterial intervention with or without prior iliac simulation. Simulator measurements, performance grading and resident surveys were recorded.Prior simulation of iliac intervention significantly improved resident performance. In particular, it resulted in less catheter placement without a wire (P=.01), shorter time to proper catheter positioning (P=.045) and use of oblique digital subtraction angiography (P=.035). Survey respondents valued the experience.Endovascular simulator training improves simulation skills. Improvement of real-world performance and generalizability remain to be shown.