Michel Foucault remains one of the most influential intellectuals in the early twenty-first century world. This paper examines the origins and impact of his first major work, Folie et déraison, on the history of psychiatry, particularly though not exclusively in the world of Anglo-American scholarship. The impact and limits of Foucault’s work on the author’s own contributions to the history of psychiatry are examined, as is the larger influence of Madness and Civilization (as it is known to most Anglophones) on the nascent social history of psychiatry. The paper concludes with an assessment of the sources of the appeal of Foucault’s work among some scholars, and notes his declining influence on contemporary scholars working on the history of psychiatry.