This article presents the background to recent developments in prison health care promising enhanced health benefits for prisoners and promoting health as a central feature of prison health care policy. It provides a description of the emergence of health promotion within the prison setting, locating prison-based initiatives, and raises questions about the fundamental philosophies underpinning current models of prison health care where the aim of health care promotion may become punitive. The need to identify health needs in prisons, the priority among them and the development of appropriate health improvement programs has been increasingly recognized in recent years. The article stresses that promoting health in prisons means challenging the “collective” factors that produce ill health rather than concentrating on “individual” resolutions. Notes, references