The history of the concept of narcissism crosses different fields concerning both mental functioning and pathology. It is not so easy to catch the difference between a certain degree of healthy narcissism, conceived as a physiological developmental step, and a primary or secondary pathologic narcissism. The idea of narcissism stands out and develops in the Freud’s thought. Because of its stratification and complexity many other authors, after him, will exploit it in many sometimes extremely different and diametrically opposite ways. There is a modern attempt at gathering “restricted” and “large” theories in order to propose a model where opposite dimensions become complementary, thus reaching an advanced conceptualization of the structure of mental apparatus, which could lead to a different way of thinking about clinical approaches and therapeutic options.