Prison inmates, like the population at large, are entitled to physiotherapy care. However, the lack of information in the literature suggests physiotherapy in prisons is not commonplace. Where it does occur, the physiotherapist is often confronted by unfamiliar and unpleasant circumstances as there are significant differences between community or hospital based practices and a prison practice. The purpose of this communication is to describe, from the author's perspective, the various factors that make a prison practice difficult. Problems relating to jail security and attitudes are discussed. Health and behavioural problems unique to prison inmates are explored and methods of dealing with them examined. The physiotherapist's role in prison health care is addressed and, finally, some ideas for increasing the profile of physiotherapy in prisons are presented.