Despite the growing numbers of incarcerated women, there still remain few systematic analyses of their unique physical and mental health needs. A descriptive design was used in a convenience sample of 30 incarcerated female offenders in a rural detention center to investigate the complex health care needs of this population and formulate appropriate community-based nursing interventions. The participants received a detailed physical and mental health assessment, as well as screening for alcohol and drug abuse. Sixty-three percent of the women reported drug problems and 80% reported alcohol problems, while 84% reported physical or sexual abuse. Serious health problems were identified, including AIDS, STDs, and delirium tremens. Scores on the Global Severity Index of the Brief Symptom Inventory showed that 70% percent of the women were in the clinical range for mental health problems. The scores on the Multidimensional Scale of Perceived Social Support were negatively correlated with the Global Severity Index on the BSI (r = -.377, p = .04) which may indicate some protective effect of social support with regards to psychiatric distress. The data demonstrate a need to develop a brief objective mental health screening test for this specific population to identify psychiatric problems that require immediate attention during the incarceration period. The results also highlight incarceration as an excellent opportunity for the advanced practice nurse to initiate focused health care interventions and other strategies which can foster incarcerated women's re-entry into the community. More research is needed in this underserved group, particularly concerning issues of maternal incarceration, STD prevention, detoxification, psychiatric treatment, and sources of social support.