Some 12 million people are eligible to vote on Sunday and Monday, in the first electoral test for Prime Minister Mario Draghi since he took office.
Mayoral elections take place in over 1,000 towns and cities in Italy on Sunday and Monday, in the first electoral test for Prime Minister Mario Draghi since he took office in February.
A low turn-out is expected on both days, but nonetheless the results from major cities such as Rome, Milan, Naples and Turin are eagerly awaited, as well as those in smaller centres.
Key questions include whether the centre-left can win in some of the more high-profile contests, as well as the performance of the far right.
A lot is at stake for Democratic Party (PD) leader Enrico Letta, who is running in a parliamentary by-election in the Tuscan city of Siena.
Former Prime Minister Giuseppe Conte, who took over as the leader of the populist 5-Star Movement in August, has been campaigning hard.
He's up against the anti-migrant, far-right leader Matteo Salvini whose League party is on the slide.
It's down from a high of 34% during the European election in 2019 to around 20% now, according to recent polls.
The League has been losing out to another far-right party, the Brothers of Italy, which may well overtake it.
More centrist elements in the party have been challenging Salvini who is still on trial for preventing a charity ship with 147 migrants and refugees on board from docking anywhere in Italy
And if he's convicted Salvini could spend 15 years in prison.
But all eyes are on the mayoral contest in Rome, which is in a mess — literally. Rubbish is rotting on the streets and even wild boars have been spotted roaming around the city.
If the current mayor of Rome, Virginia Raggi from 5-Star, loses then Giuseppe Conte's leadership of the movement may look doomed before it's even properly begun.
Some metro stations in the city centre, awaiting sorely needed escalator repairs, have been closed for months.
Raggi is running for a second term and the sorry state of basic municipal services such as rubbish collection and street maintenance is a major issue, just as it was the first time around.
In 2016, she was a 37-year-old, little-known lawyer and city council member. She quickly became one of the most prominent faces of the 5-Star Movement, a grass-roots populist phenomenon created a decade earlier by Italian comic Beppe Grillo, and, as of 2018, the largest party in the national Parliament.
Some commentators say the Italian capital is in a worse state now than when Raggi was elected as mayor. After five years, Rome has been plagued by a high turnover of city commissioners and heads of public agencies.
None of the 22 candidates for mayor this time is given any real chance of clinching more than 50% of the vote, meaning it is likely that the top two finishers will meet in a runoff two weeks later.
Several polls, whose publication is banned in the last two weeks before the election, have indicated that at most, 15% of voters want five more years of Raggi, though a large percentage of people said they were undecided.