The most important lines in the history of Genoese psychiatry are presented. Eight milestones can be identified: (1) the construction of the first madhouse in 1841; (2) the continual increase from that period in the number of in-patients, and the lack of adequate accommodation; (3) the beginning of the teaching of psychiatry at the University of Genoa; (4) the stormy debate on the construction of a great madhouse near Cogoleto; (5) the opening of the madhouse at Quarto and the discussion on its enlargement; (6) the attempts to introduce the non-restraint system at the beginning of nineteenth century; (7) the writing of Camillo Tomei and the work of Luigi Maria Bossi against the abuse of psychiatry; (8) the awakening, beginning in the late 1960s, of interest in psychiatry, the closure of the old Italian asylums, and the birth of community psychiatry in 1978.