The care of incarcerated individuals infected with the hepatitis C virus (HCV) is part of a complex healthcare and criminal justice pathway. The advent of direct-acting antiviral (DAA) treatments for HCV infection, which enable viral cure in most cases, contributes to the national strategy to eliminate HCV by 2025. A review of the literature and available national data was conducted to compile information from three metropolitan regions (accounting for 40% of the prison population). The epidemiology and care of prisoners are poorly documented, with data largely outdated. The Coquelicot survey showed that the prison population engaged in behaviors associated with a high risk of HCV infection, which is exacerbated in the context of incarceration. Screening upon admission to detention was 93% in 2010 (Prevacar), 70% in 2015 and 72% in 2017 (two practice studies), and 56.5% in 2016 (Île-de-France). The seroprevalence and prevalence of HCV infections were 4.8% and 2.5% in 2010 (Prevacar) and 2.9% and 1.1% in 2017 (Fresnes). In the absence of a national database on HCV medical care, the CNS survey showed that care pathways were heterogeneous, with fewer than one in two inmates accessing treatment, with insufficient screening being the major obstacle. The establishment of a sustainable data collection system and the strengthening of screening for effective treatment appear essential for the eradication of HCV in the prison system.