Outpatient health care service providers face increasing pressure to improve the quality of their service through effective scheduling of appointments. In this paper, a simulation optimization approach is used to determine optimal rules for a stochastic appointment scheduling problem. This approach allows for the consideration of more variables and factors in modeling this system than in prior studies, providing more flexibility in setting policy under various problem settings and environmental factors. Results show that the dome scheduling rule proposed in prior literature is robust, but practitioners could benefit from considering a flatter, “plateau-dome.” The plateau–dome scheduling pattern is shown to be robust over many different performance measures and scenarios. Furthermore, because this is the first application of simulation optimization to appointment scheduling, other insights are gleaned that were not possible with prior methodologies.