This chapter investigates Italian Lacanian aesthetics, which centres on the real and moves beyond pathographic models and hermeneutic interpretations. This ‘aesthetics of the real’ examines how the extra-symbolic dimension of the real is integrated into the representational framework of art. The real remains irreducible to meaning or interpretation, functioning as the unconscious of art. Italian Lacanian aesthetics also rethinks realism in the arts, marking a shift from traditional aesthetic qualities like beauty and harmony towards abjection, formlessness, and degradation. This realism is described as extreme, traumatic, or psychotic because the real disrupts the imaginary-symbolic fabric of the artwork. The chapter concludes with an analysis of the film Reality, which transcends the binary of everyday versus media reality, exposing the fictional fabric of reality itself.