Bipolar disorder is characterized by distinct periods of depressed and elevated moods and can have significant impacts on incarceration. In this chapter, the topics covered include the challenges in diagnosing bipolar disorder in a carceral setting, the factors contributing to the presentation of bipolar disorder in the prison settings, the management of bipolar disorder in prisons, the legal considerations of AICs with bipolar disorder, and the challenges of continuum of care upon release from prison. The authors hope that the content presented will provide an enhanced appreciation of the significance of bipolar disorder in individuals who are treated within the carceral system.