In 1968 an inmate riot at Central Prison resulted in the death of 6 inmates and injuries to more than 70 others. The prisoners demanded the formation of a grievance committee that included inmate members and the return of inmates confined to higher-security areas to the general prison population. In the course of the riot, prisoners burned several buildings and assembled a huge cache of weapons.
The original complex has undergone extensive renovation. In the 1940s a prison industries facility was erected to house a state license plate fabrication operation and print shop, and in the 1960s an acute care hospital opened, supplemented by two mental health wings built in the 1970s. A nearly $38 million renovation project of the North Carolina Department of Corrections in the 1980s added additional inmate housing and administrative office space.
Central Prison's infirmary and mental health facility serve the inmate population from across the state, and it is the intake facility for all male felons over the age of 22 with sentences longer than 20 years. The prison also contains the state's execution chamber, deathwatch area, and men's death row. Inmates receive a variety of job assignments in prison industries, the kitchen, or laundry; they also work as barbers, janitors, and clerks. The prison offers substance abuse therapy, GED and college courses, and worship services.