Despite the increased attention in research for correctional systems to identify inmate sexual assault, the incidence of inmate sexual victimization in U.S. correctional institutions remains unknown and the treatment of inmate victims has been significantly ineffective and to some extent nonexistent. The patterns and perceptions about an inmate will often shape the treatment that they receive from other inmates and correctional staff. Sexual victimization affects the victims physically, emotionally, socially, and spiritually. Perpetrators of sexual victimization in prison often become the most important person in the life of the victim. This is due to the unique structure of incarceration, an environment of captivity. Male sexual assault victims experience additional humiliation, thereby complicating their recovery. Several challenges facing male victims are presented and discussed. Because of the belief by both inmates and staff that there are few real victims, it becomes critical that practitioners avoid the “secondary injury” to victims that gives off a perceived rejection or lack of support from staff or the projection of feelings of blame onto the victim. The first priority for medical intervention in sexual victimization incidents is to treat imminent injuries and minimize life-threatening events. The last medical intervention involves the process of collecting forensic evidence from victims. Several major mental health issues to consider following inmate sexual assault include: suicide, post-traumatic stress disorder or rape trauma syndrome, and other psychiatric disorders. In addition to the treatment intervention, the management of inmate sexual assault victims or interdisciplinary intervention must be considered in order to ensure the safety and security of inmate victims. By utilizing empirical data, encouraging state-of-the-art interventions, establishing clear and concise protocols, and increasing staff training and communication, there is a chance to effectively respond to the crisis of inmate sexual assault. Tables and references