Background: Mass casualty incident triage is essential in determining the priority of care for patients to maximize the number of survivors. This study aimed to evaluate the effectiveness of two different triage systems, SALT and START, in a simulated mass casualty event. Methods: participants were recruited and randomized into three groups: SALT-trained, START-trained, and untrained control. Participants performed triage on simulated patients pre- and post-training. Data was collected before and after implementing a training program that consist of a brief lecture and open discussion of 10 minutes for each triage system, and it was conducted in a group format. Results: A total of 60 participants were included in our analysis. The results showed that both SALT and START training significantly improved triage accuracy compared to the untrained control group. However, there was no significant difference in accuracy between the SALT and START groups. Additionally, both groups showed significant improvements in triage time post-training. Conclusion: These findings suggest that both SALT and START are effective triage systems in a simulated mass casualty event and highlight the importance of proper training for accurate and efficient triage. DOI: