Tuberculosis (TB) remains a significant public health concern in correctional facilities due to overcrowding, poor ventilation, and inmate mobility. This cross-sectional study assessed the roles of 298 Prison Health Volunteers (PHVs) in TB surveillance at three Central Correctional Institutions for Young Offenders in Thailand. Although most PHVs demonstrated low knowledge and moderate attitudes, they performed well in key health education and case detection tasks. Significant associations were found between higher knowledge and favorable attitudes with better TB control practices (p = 0.027 and p = 0.005). These findings suggest that experiential and contextual factors may compensate for knowledge gaps. Despite ongoing challenges—including limited training and paper-based systems—PHVs remain pivotal in TB control. Strengthening their capacity through digital tools and structured support is essential. The Royal “Pan Suk” Project represents a promising, community-led model aligned with His Majesty King Maha Vajiralongkorn’s vision of promoting prison health equity and advancing TB elimination.