With tougher sentencing laws, an increasing number of individuals are finding themselves spending their final years in life in prison. Drawing on a sample of 327 women over the age of 50 incarcerated in 5 Southern states, the present study investigates the relationship between numerous health variables and the Templer Death Anxiety Scale (TDAS). Qualitatively, the article also provides personal accounts from inmates that serve to reinforce death fears when engaging the prison health care system. Participants reported a mean of 6.40 on the TDAS indicating a substantial degree of death and anxiety when compared to community samples. both mental and physical health measures were important indicators of death anxiety. Qualitative information discovered that respondents' concerns about dying in prison were often influenced by the perceived lack of adequate health care and the indifference of prison staff and other instances of penal harm.