Background: General surgery residents need to master the hand-sewn bowel anastomosis (HSBA) technique. However, practice opportunities outside of the operating room are rare, and commercial simulators are often costly. The objective of this study was to assess the efficacy of a new, affordable silicone small bowel simulator, made with a 3D-printed mould, as a training tool to learn this technique. Methods: This was a single-blinded pilot randomized controlled trial comparing 2 groups of 8 junior surgical residents. All participants completed a pretest using an pensive, 3D-printed simulator. Next, participants randomized to the experimental group practised the HSBA skill at home (8 sessions), while those randomized to the control group did not receive any hands-on practice opportunities. A posttest was done using the same simulator used for the pretest and practice sessions, and the transfer test was performed on an anesthetized porcine model. Pre-, post- and transfer tests were filmed and graded by a blinded evaluator based on technical skills, procedural knowledge and quality of the final product. Results: The experimental group significantly improved after practising with the model (p = 0.01), while an equivalent improvement was not noted in the control group (p = 0.07). Moreover, the experimental group's performance remained stable between the posttest and the transfer test (p = 0.95). Conclusion: Our 3D-printed simulator is an affordable and efficacious tool to teach residents the HSBA technique. It allows development of surgical skills that are transferable to an in vivo model.