This chapter considers the development of peer-based approaches in promoting prison health in England and Wales and presents insights into how young adult prisoners perceive and experience these roles in the prison environment. Alongside the benefits of taking on a peer role, the chapter explores prisoners’ views of the implementation and the potential utility of peer-based approaches for health within the wider prison community. The findings are discussed in relation to the potential impact of peer initiatives in seeking to develop and implement the more integrated and innovative approaches that have been called for in this domain in seeking to reduce health inequalities.