The number of older people in prison has quadrupled in the UK in recent years, such that older prisoners now make up 2.6% of the total prison population, despite the fact that the number of offences committed by older adults has remained static. Older prisoners have high levels of psychiatric and physical morbidity, and forensic psychiatric services are receiving increasing numbers of referrals of older adults. In the past, few of these referrals resulted in admissions to secure psychiatric beds, however, reflecting a reluctance by forensic psychiatrists to admit older adults, who were perceived as being at risk from younger patients. Over the past 10 years, however, specialist secure inpatient units have been established in the UK for the assessment and management of older mentally disordered offenders. This seminar will explore the research evidence and clinical experience relating to this group of patients.