Prescribed burning has been carried out since the late 1970s in several southern European countries. Italy hosted some pioneer experiences in the early '80s, but these did not follow up into practical implementation, and few studies and applications were carried out in subsequent years. In the last decade, a new interest arose and several experiences were carried out. We aim to illustrate the limitations, advances and challenges of prescribed burning in Italy by reviewing the national literature of the last 40 years on this subject. Unfavorable land characteristics, conflicting management goals, a hostile socio-cultural environment, and an inadequate regulatory framework have supposedly limited the application of prescribed burning in Italy. Nevertheless, in the last 20 years the legislation at the regional level has been updated to consider the use of fire, and new procedures to authorize prescribed fires allowed for experiments and application, even within National Parks. From 2005 to 2012, prescribed burning programs for fire hazard reduction, forest and range management, biodiversity conservation and firefighter training were implemented throughout Italy. Several vegetation and fuel types were involved (e.g., broadleaved and coniferous forests, Mediterranean and continental shrubland, grassland, slash). Studies on fire behavior and effects helped to set prescriptions for specific objectives and environments. Results were transferred to professionals through training sessions. Some of the challenges ahead are improving the legislative framework, e.g., by introducing a certification for the use of fire, and addressing issues of pastoral fire through conflict resolution programs. Prescribed burning in Italy could be developed by committing to carry out ecological studies on its implications to silviculture, range management and habitat conservation.