Italy was the first western country reached by the spread of SARS-CoV-2. It clustered in the first wave in the Lombardy region and in its surrounding areas. In this chapter, the authors delineate first the timeline and the rapid, highly dynamic evolution of the pandemic crisis in the country, focusing in particular on the Lombardy region, which was by far the hardest hit region with a very high number of hospitalizations, infected persons, and deaths. The chapter is organized in four sections. The first provides basic information needed to understand the pandemic governance in Italy, and the second illustrates the timeline of the emergency management in the first wave, until June. The third addresses criticalities and positive aspects of the response, and the fourth discusses two main aspects, namely the use of data and the interface between science and policy.