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In 1884, Sargent asked a Louisiana-born Parisian socialite named Virginie Gautreau to sit for a portrait, not as a commission but because he wanted to paint her: pale skin, a profile she was famous for, and a black dress with a jeweled strap slipping off one shoulder. When it went on display at the Salon as Portrait de Mme***, everyone in Paris knew exactly who it was, and the falling strap read as an open admission of the affairs she was already rumored to be having. The reaction was brutal. One critic called her a clown in a pantomime, and Gautreau's mother reportedly came to Sargent's studio in tears begging him to withdraw it.

Sargent repainted the strap back onto her shoulder, but the damage to his reputation in Paris was done, and he left for London within the year. There he rebuilt his career almost from nothing, painting the British aristocracy and wealthy American expatriates, and by the 1890s he was the most sought-after portrait painter in the English-speaking world.

He kept the original Madame X in his own studio for decades, refusing to sell or exhibit it publicly, and only let it go to the Metropolitan Museum in New York in 1916, calling it the best thing he had ever painted.