Incarceration and substance use disorder (SUD) are closely related. SUDs are associated with almost all the steps of incarceration, and also with recidivism. In this narrative review, we will evaluate the existing evidence regarding the prevalence of substance use, and the efficacy of comprehensive management of SUD in prison settings. The prevalence of substance use is significantly higher in the prison population around the world. The criminalization of substance use aggravates the situation and also limits treatment access. There is a dearth of research on SUD s in low- and medium-income countries including India. Evidence suggests effective management of SUD in prison settings can improve quality of life, reduce high-risk behavior, and minimize post-discharge overdose deaths in patients with opioid dependence. Effective withdrawal management and maintenance therapy including opioid substitution treatment should be available in a prison setting. Comprehensive management of SUD in the prison population will ascertain the right of health for the prison population in particular and improve the well-being of society as a whole.