Despite the disproportionately high prevalence of serious mental illness in the prison population, little attention has been given to medication adherence amongst prisoners. To investigate adherence and satisfaction with antipsychotic medication, a mixed methods study, using clinical measures and qualitative interviews, was undertaken with 44 prisoners across three prisons. This article draws on the qualitative findings to examine prisoners' subjective experiences of medication and produces a contextualised understanding of adherence within a prison environment. The stabilising effect of the prison routine appeared to have a beneficial impact on adherence, but collecting medication from a central point in the prison seemingly discouraged compliance. In common with the quantitative data (as reported by Gray, Bressington, Lathlean, & Mills (2008) in Journal of Forensic Psychiatry and Psychology, 19, 335–351), most respondents valued the efficacy of their medication, resulting in their adherence. This reinforces an earlier conclusion that interventions to enhance medication adherence should focus on helping patients recognise the personal relevance of medication.