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This book describes the water sector as it is structured in Italy. The first part describes the legal framework which rules the sector in Italy, its evolution since the last 20 years, and its weaknesses. The second part describes the governance of Italian water utilities, distinguishing full public-owned companies from public-private partnership and private companies. The third part reports insights on water utilities performance to enquire the presence of economies by scope, scale and density in the Italian water sector, and to verify the presence of any differences in terms of efficiency and tariffs among public and private firms. The fourth part describes the investment policies carried out by water utilities, observing the total amount of per capita investments and the actual realization of planned investments. The fifth part describes if and how utilities applied water conservation practices to incentive the sustainable water use.