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The paper aims to present Jacques Lacan's study on the theoretical foundations and clinical implications of the use of knot topology in the psychoanalytic context. The configuration of the Borromean knot—namely an interlacement consisting of three rings whose bond is based on a global triadicity—lends itself to offer an important support for thinking about the intertwining of the three registers of human experience: the Imaginary, the Symbolic, and the Real. These three registers represent fundamental aspects of human life, and the Borromean knot allows us to consider the forms and dynamics of their reciprocal and global interaction. Finally, Lacan introduces the need for a fourth ring, the so-called sinthome, which performs a substitute function to hold together the undoing of the Borromean knot. The sinthome (unlike a medicalized vision of the symptom) represents an element of singularity that a subject identifies in her history to continue living and be able to face the disquieting experience of the Real and its impossibility to be represented.