Simulators have been traditionally used for centuries dur- ing medical training as the trainees have to improve their skills before practicing on a real patient. Nowadays mechatronic technology has open the way to more evolved solutions enabling objective assessment and dedicated pedagogic scenarios. Trainees can now practice in virtual en- vironments on various body parts, with current and rare pathologies, for any kind of patient (slim, elderly ...). But medical students need kines- thetic feedback in order to get significant learning. Gestures to acquire vary according to medical specialties: needle insertion in rheumatology or anesthesia, forceps installation during difficult births ... Simulators reproducing such gestures require haptic interfaces with a variable ren- dered stiffness, featuring commonly called Variable Stiffness Actuators (VSA) which are difficult to embed with off-the-shelf devices. Existing solutions do not always fit the requirements because of their significant size. In contrast, pneumatic technology is low-cost, available off-the-shelf and has a better mass-power ratio. Its main drawback is its non-linear dynamics, which implies more complex control laws than with electri- cal motors. It also requires a compressed air supply. Ampère research laboratory has developed during the last decade haptic solutions based on pneumatic actuation, applied on a birth simulator, an epidural nee- dle insertion simulator, a pneumatic master for remote ultrasonography, and more recently a needle insertion under ultrasonography simulator. This paper recalls the scientific approaches in the literature about pneu- matic actuation for simulation and tools in the medical context. It is illustrated with the aforementioned applications to highlight the bene- fits of this technology as a replacement or for an hybrid use with classical electric actuators.