The number of older prisoners is increasing and, with reforms in the prison health service, there is a requirement to provide equity of access to standard healthcare services. The health of older prisoners is often poor, with high levels of psychiatric and physical illnesses, compounded by poor access to appropriate rehabilitation and resettlement services. A recent case presenting to our department highlighted these deficits and illustrated how specialist input from a geriatrician could be useful to older prisoners (see Appendix 1, available at www.ageing.oxfordjournals.org). We propose that regular penitentiary visits may be an important new role for geriatricians at a supra-regional level.