Salience is an integration process that allows to give attention to internal or external stimuli which grow in relevance becoming able to influence thoughts and behaviors. On the contrary, aberrant salience leads to the attribution of significance to innocuous or natural stimuli. Aberrant salience plays a basic role in the early phases of psychosis, mainly in the development of "revelation", but it also contributes to maintain the disorder. Nowadays, the current and specific instrument to assess this symptom is the Aberrant Salience Inventory (ASI) both in clinical and non-clinical samples. Furthermore, the documented interrelation between the dysregulation of the salience attribution and the dopamine system could explain the correlation between aberrant salience, substance abuse and development of psychotic symptoms. The assessment of aberrant salience in people with prodromal symptoms or at risk to develop them, could be a noteworthy clinical tool both for diagnostic and prognostic purposes. The aim of this review is to analyze the concept of salience: definition, historical and psychopathological background, neurobiological underpinnings, association with substance abuse, assessing instruments and clinical features.