Since Freud's (1911) explication of the nature of paranoia, much has been written concerning the dynamic underpinnings of the illness but less have been detailed regarding its manifestations structurally. This essay, with its case illustration, attempts to detail the relationship between paranoia and the ego-ideal. Both Blos' (1974) ideas on the negative Oedipus complex and Kohut's (1966) ideas on the developmental line of narcissism prove to be useful ways of linking the clinical picture of paranoia to the psychic structure of the ego-ideal. Both technical aspects of treatment as well as theoretical understandings are explored.