Objective: the objective of this study is to analize the challenges encountered and establish a directly observed tuberculosis treatment in a maximum security penitentiary. Method: a qualitative approach was adopted for the exploratory descriptive study. Results: the respondents’ contributions indicate an exclusionary environment for those diagnosed with tuberculosis and fear of cross contamination. Knowledge about the disease is minimal, but treatment is eagerly accepted. However, a multidisciplinary team is not available to continually accompany the directly observed treatment. Conclusion: in light of these findings it the implementation of effective health promotion, prevention and recuperation measure for the detainees have therefore become necessary.