The Azzurri outscored England three tries to two, but the boot of George Ford saved Steve Borthwick’s men at the Stadio Olimpico.
Here, Standard Sport's rugby correspondent Nick Purewal looks at the individual England performances after a mixed showing at best.
Freddie Steward: 6
Solid as ever as the last line of defence but unable to add much in attack as England laboured on the ball again.
Tommy Freeman: 7
Looked comfortable on the ball and his intervention stepping off his wing conjured Elliot Daly’s try when England were struggling for incision.
Henry Slade: 5
Failed to give England the poise they so desperately crave in midfield. Such a talented player with so many attributes that ought to help him excel at Test level, and yet England have never maximised his output.
Fraser Dingwall: 5
Struggled to impose himself or find his niche in this team on his Test debut. A tricky afternoon, but England should give him more chances to find his feet.
Elliot Daly: 6
Finished his try well and tried to put himself about amid England’s once again stilted attack. Shown a late yellow card.
George Ford: 6
Kicked well off the tee but struggled to get England going in attack. England lack for sufficient variety with Ford, Dingwall and Slade as a midfield three.
Alex Mitchell: 6
Struggled to find his usual pacy rhythm around the fringes, but did pull that through at times. Took his try well and still remains England’s best No9.
Joe Marler: 7
Scrummaged well, and showed his endurance by going almost the full distance. Vital to England’s lineup right now.
Jamie George (c): 6
Could not inspire the sort of upbeat start that England so craved here, but was tidy in all aspects of his performance and obviously has more in the tank for the coming weeks.
Will Stuart: 6
Showed up well in the scrum but England will ask more of him in the loose as this tournament unfolds.
Maro Itoje: 7
At times the speed of his almost acrobatic movement is spectacular, and certainly dug England out of a few holes here.
Ollie Chessum: 6
Made one costly mistake rushing out of the line but settled into his usual rhythm as the game unfolded.
Ethan Roots: 7
An extremely promising Test debut from a man who looks a natural at the level. England have secured themselves a gem here, now they have to help him shine.
Sam Underhill: 6
Not quite up to his usual lofty standards, but the balance should level out in this new-look back-row in the next few weeks.
Ben Earl: 6
Aggressive and uncompromising, but not quite able to punch the holes on the ball that he would have wanted.
Theo Dan (for George, 73): 6
Snaffled one ball with impressive pace, in a solid cameo.
Beno Obano (for Marler, 75): 6
A short showing but one that ought to build confidence in the form Bath prop.
Dan Cole (for Stuart, 55): 6
Gave away a puzzling scrum penalty but settled back in, and remains a hugely reliable option despite his advanced years.
Alex Coles (for Chessum, 72): 5
England struggled to stay on top of the tight work as the game broke up towards the latter stages, and Coles still has work to do to hit the right levels.
Chandler Cunningham-Smith (for Underhill, 66): 6
Pulled off a try-saving tackle that proved crucial to England’s win given Italy’s last-ditch try. Could develop into a major weapon for England at blindside if he can bolster his lineout work still further.
Danny Care (for Mitchell, 58): 6
Could not push the pace around the fringes as England struggled to get their phase play running smoothly.
Fin Smith (for Ford, 66): 6
Unable to pull off any magic but this was a solid start and having his debut under his belt will no doubt fill Smith with confidence.
Immanuel Feyi-Waboso (for Freeman, 77): 6
A very short outing for the Exeter man, but even being in position to make his debut after such a quick rise should represent a job very well done.