Not as bad as most of these reviews would lead you to believe.
Prison Tycoon is not realistic in any sense of the word. The graphics are, let me be honest, terrible. The music gets annoying after about an hour, the sound effects are bland and boring, and the game is quite repetitive. You can easily predict what the prisoners are going to do throughout the day, when they are most likely to riot and fight, where they will go, and when you'll need to call guards and doctors.
The prisoners constantly fight, which adds realism and fun to the game, but these prisoners will ALMOST NEVER go to get medical help when they are injured. Sometimes they will, but other times they will either need you to send a doctor their way or put them in the medical building yourself, but even that doesn't work sometimes. When you have built a large prison and have gained many inmates, you will see that ALOT of inmates die because they don't go get medical aid after a fight.
However, this game could provide many hours of entertainment. For twenty dollars, it's not a horrible game. However, you can tell that this is a total budget title with little effort put into developing it.
Luckily, this game doesn't share the same problem as it's successor, Prison Tycoon 2 : Maximum Security. With this, I mean that this game doesn't CRASH CONSTANTLY like Prison Tycoon 2 does.