Currently, all states allow juveniles who commit certain offenses to be waived from jurisdiction of the juvenile court to be tried and sentenced in adult criminal court. This essay reviews approaches for housing juvenile offenders in adult correctional facilities (i.e., straight adult incarceration, graduated incarceration, and segregated incarceration) and the special considerations for prison management and service delivery. The essay begins with a summary of the history of juvenile justice, focusing primarily on transfer to adult court and subsequent adult incarceration. Next, a description of the number of youths facing adult punishment is provided. The experiences of youths inside adult incarceration facilities and the effects of transfer to adult court on postrelease recidivism are discussed, followed by a review of individual states’ approaches to housing youths in adult prisons.