Aims - The article describes the evolution of Outsider Art from the birth of its term in 1972 to the present and its emancipation from the margin to the markets, still in progress. Results - Tracing the evolution of Outsider Art evidences a stark contradiction. On one hand the art world of collectors, historians, art dealers and admirateurs, accepts without reservation artwork that for many years was kept in a marginal position, compared to the “insider” art establishment. On the other hand art experts can not agree on a universal definition of this category of art. The particular status of the outsider artists is one of the reasons that causes difficulty in reaching a definition of Outsider Art. Significant atelier experiences with psychiatric patients delineate the difference between an Outsider Art work and a work produced by Art Therapy. Conclusions - The art market of art dealers and art collectors can be identified as the place where these contradictions dissolve, and where the Outsider Art category finds its ultimate legitimation and international recognition.