It is located adjacent to the federal system prison (Federal Correctional Institution, Otisville), but each facility operates separately from the other and they are otherwise unrelated.

The site was used as a tuberculosis sanitarium (1906–1955), a Division of Youth facility (Otisville Training Facility, up to 1972), and briefly a drug treatment center, before it became a state prison.

[1] A sawmill for lumber and maple syrup production were soon introduced for prisoner work.

Due to the length of the prison fence and rough terrain, exterior guards are mounted on horses.

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