Although hidden from sight, within the correctional system, there is a disproportionate percentage of inmates with psychiatric illness. With an aging population and inmates with lengthy sentences, there is additional concern about older inmates dealing with their chronic psychiatric illnesses including the development of neurocognitive disorders and a host of gathering medical comorbidities. Correctional institutions are arguably ill equipped to deal with a growing and aging medically and psychiatrically ill population. The call for subspecialty service from geriatric psychiatry in the correctional system is almost certain, and therefore the time for careful consideration for the delivery of this service is now, before the crisis declares itself.