The stigmatization and mass incarceration of the elderly is international in scope but is particularly problematic in the United States, which has the largest incarceration rate per capita. This chapter reviews the intersectional issues of age, health, mental health, legal, economic, and social care-related needs and rights of justice-involved older adults. It provides an overview and scope of the problem, promising and best practices, and policy and population trend issues that perpetuate or reduce ageism and other forms of stigmatization, neglect, and mistreatment of this population, and trends and future issues. The biggest challenges for professionals and prisons to best serve this population is to develop competencies to work effectively at the intersection of aging, health/mental health, and the criminal justice system. Effectively addressing stigma and oppression based on social identities, such as age, race, trauma and incarceration histories, and offense type is an integral aspect to prevent or effectively intervene with this population at the programming and policy level. The chapter concludes with select case examples to illustrate the diversity among the aging prison population.