This paper explores the effort to reform conditions of confinement for pretrial detainees in the Boston, Massachusetts metropolitan area through the Inmates of the Suffolk County Jail lawsuit. Inmates of the Suffolk County Jail v. Eisenstadt, 360 F.Supp. 676, 687 (D. Mass. 1973). The Suffolk County Jail, called Charles Street, was examined by seven different government commissions between 1949 and 1971 and all found the facility to be inadequate. Section II of the paper considers the environment for litigation at the time of this case from a variety of perspectives, including the prisoners' rights movement, the political dynamic in Boston with other efforts to reform public institutions, and the failing conditions at the Charles Street Jail. Section III examines the history of the litigation itself, focusing on the lengthy efforts to build a new jail, the only way to cure the conditions of confinement at the Charles Street Jail. Section IV analyzes the litigation itself from the perspective of institutional reform litigation theory, concluding that the litigation successfully overcame the failure of the political process by coercing county and state officials into fulfilling their responsibilities under state and federal law. Though this case lowered the standard of proof to modify consent decrees and was concluded by application of the Prison Litigation Reform Act (PLRA), Inmates of the Suffolk County Jail proved successful in providing constitutional conditions of confinement for pretrial detainees in the Boston metropolitan area.