Although women represent an increasing number of state prison inmates, they are studied less than their male counterparts are. Incarcerated women have higher rates of depression than both community samples and incarcerated men. The diagnosis and treatment of depression in incarcerated women is complicated by the presence of substance abuse, psychosocial stressors, medical problems, and personality disorders. This article focuses on the role of the community-based primary care provider in assessing, diagnosing, and treating the depressed female offender confined in state prisons.