Background: Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) positioning require a combination of theoretical knowledge and practical skills. Traditional teaching methods may offer limited opportunities for repeated hands-on practice.Objective: To evaluate the effectiveness of virtual simulation-based training in improving CT and MRI positioning knowledge and practical competency among undergraduate radiography students.Methods: A prospective pre-test and post-test educational intervention study was conducted among 30 undergraduate radiography students. Participants completed a four-week virtual simulation training program consisting of CT and MRI positioning modules. Knowledge was assessed using a 25-item multiple-choice questionnaire, while practical competency was evaluated through an Objective Structured Clinical Examination (OSCE)-based assessment within the simulation environment. Student perceptions regarding the learning experience were also collected using a structured questionnaire. Data were analyzed using descriptive statistics and paired t-tests, with statistical significance set at p < 0.05.Results: All 30 participants completed the study. The mean knowledge score increased significantly from 13.8 ± 2.9 before training to 21.2 ± 2.1 after training (p < 0.001). Similarly, the mean practical competency score improved from 14.6 ± 3.2 to 23.4 ± 2.8 (p < 0.001). More than 90% of students reported increased confidence, improved understanding of CT and MRI positioning procedures, and satisfaction with the simulation-based learning experience. Most participants recommended the integration of simulation training into the radiography curriculum.Conclusion: Virtual simulation-based training significantly improved both theoretical knowledge and practical competency in CT and MRI positioning among undergraduate radiography students. The findings support the incorporation of simulation-based learning as a valuable supplement to traditional radiography education.