On 29 August 2018, Sotoudeh began a hunger strike to protest her detention and government harassment of her family and friends.

On 11 March 2019 Nasrin Sotoudeh was sentenced in two different trials to 38.5 years in prison and 148 lashes and was denied access to a copy of the verdict against her. She was only permitted to see the text of the sentence and to note the charges of which she was convicted. One of the charges against her was "membership in an illegal group", referring to her membership of Legam, a campaign to abolish the death penalty in Iran. According to Article 134 of the Islamic Penal Code, and given the high number of charges against her, only the most severe punishment will be enforced. However, given the high number of charges against her, it is unclear how much of the sentence she will have to serve. [Front Line Defenders]

On 27 July 2020, her husband, Reza Khandan, reported that his wife's bank accounts had been blocked by the Tehran Prosecutor's Office. Reza Khandan believed this to be the beginning of the seizure of the family's assets.

On 10 August 2020, Nasrin Sotoudeh began a hunger strike to protest the continued imprisonment of human rights defenders and prisoners of conscience in Iran. In a letter outlining her reasons, she highlighted that COVID-19 has only served to exacerbate the already poor conditions for prisoners in Iran. In September she was hospitalised after her physical condition worsened following weeks of hunger strike. Her strike ended in late September after 46 days.

On October 20, Sotoudeh was transferred from Evin Prison in Tehran to Qarchak, a women's prison outside the city that has been blacklisted under United Nations human rights sanctions.

7 November 2020. Sotoudeh was temporarily released from prison after concerns mounted over her deteriorating health. Her temporary release came weeks after she was moved to intensive care in a hospital in Tehran following a lengthy hunger strike. [Al Jazeera]

2 December 2020: Nasrin Sotoudeh was returned to Qarchak prison despite the fact that medical experts recommended the extension of her medical leave for a further two weeks. [Al Jazeera]

Queen's University conferred an honorary doctorate of Law. Accepting it on her behalf was Irwin Cotler, Sotoudeh's international legal counsel and former Minister of Justice of Canada. [Queen's Gazeette 23 January 2021]