Individuals with borderline personality disorder (BPD) face considerable difficulties, both in terms of their symptom and functional status, as well as in attempting to obtain professional help. Their exclusion from appropriate mental health care and opportunities for recovery can be examined using the social construct of marginalization. Pervasive attitudes among clinicians, health care administrators, and policy-makers perpetuate the marginalization of BPD within systems of mental health care. Patients with BPD may be regarded as not suffering from a legitimate disorder, comprising a minority of the clinical population, and/or being a chronic drain on health care resources. Lack of suitable mental health services may be rationalized based on these attitudes. Considerable development in the empirical understanding of BPD challenges these stigmatizing attitudes and calls for critical questioning of the marginalized status of patients with BPD.