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Little guidance exists for surgeons seeking to provide equitable care for these patients.<\/jats:p><\/jats:sec><jats:sec id=\"ab-srv250003-2\"><jats:title>Observations<\/jats:title><jats:p>No national statistics are available on the need for surgery among incarcerated people. Autopsy data suggest that nearly a quarter of deaths among incarcerated individuals were attributable to causes that could have been treated with surgery, yet few received surgical care before death. Across the spectrum of custody, including police detention, jail, prison, probation, and parole, access to consistent preoperative and postoperative care are major challenges, as is sustaining appropriate levels of privacy and communication. Incarcerated people are often accompanied by guards, preventing privacy. Patients are shackled to hospital beds, restricting mobility. For incarcerated individuals, access to postoperative medication may be curtailed when they return to jail or prison. To be effective advocates for patient-centered care and to achieve the best outcomes, surgeons must remain vigilant to specific barriers to care.<\/jats:p><\/jats:sec><jats:sec id=\"ab-srv250003-3\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>Individuals in law enforcement custody have particular needs regarding communication, surgical planning, and perioperative and postoperative care. Clinicians must remain alert to these challenges and serve as advocates for these marginalized patients, even adjusting their care practices. 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