This paper examines how Fyodor Dostoevsky was used as an example in the debate over genius as a pathological phenomenon in nineteenth century medicine and criminal anthropology. When Dostoevsky’s novels became known in Western Europe medical interest in the relation between genius and insanity reached its pinnacle. A known epileptic, Dostoevsky was exceptionally well suited to illustrate Cesare Lombroso’s theory of genius as an epileptoid psychosis. Dostoevsky was also claimed as an example by the rivalling Lyon school, whose representatives argued that Dostoevsky’s life and works demonstrate that genius is a higher form of health rather than a pathological deviation.