U.S. prisons have a court-affirmed mandate to provide health care to prisoners. Given this mandate, we sought to determine whether use of prison health care was equitable across race using a nationally-representative sample of Black and White male state prisoners. We first examined the prevalence of health conditions by race. Then, across all health conditions and for each of 15 conditions, we compared the proportion of Black and White male prisoners with the condition who received health care. For most conditions including cancer, heart disease, and liver-related disorders, the age-adjusted prevalence of disease among Blacks was lower than among Whites (p<.05). Blacks were also modestly more likely than Whites to use health care for existing conditions (p<.05), particularly hypertension, cerebral vascular accident/brain injury, cirrhosis, flu-like illness, and injury. The observed racial disparities in health and health care use are different from those among non-incarcerated populations.