Most guides to the best places to live in Italy rank towns by charm. That works for a holiday. If you are moving, three things vary by region in ways that affect daily life, and they do not point the same way.
Healthcare performance. Whether the local population is growing or shrinking. And which tax regime the address makes available.
The regions with the most generous tax treatment score worst on healthcare. That tension sits at the centre of the decision, and almost nobody writing about Italian towns mentions it.
Last reviewed: September 2026.
At a glance
- Healthcare is regional. Veneto, Emilia-Romagna and Tuscany lead. Calabria, Molise and Sicily sit at the bottom, and three regions failed the minimum standard in 2024.
- Population is diverging. The North grew by 2.2 per thousand in 2025. The Centre was flat. The South lost 3.1 per thousand.
- The 7% tax regime is southern only, and only in towns under 30,000 residents.
- The flat tax for new residents works anywhere, so it does not constrain location at all.
- Property ranges widely. Milan runs around €5,645 per square metre against a national average near €1,130.
- Italy has roughly 7,900 comuni. The municipality, not the region, decides most of what follows.
What actually varies by region?
Italy devolves health to the regions, so the standard of care genuinely differs by where you register. Tax treatment differs too, though less than people assume. Population trends differ sharply. Property costs differ by a factor of five between the most and least expensive markets.
Climate, food and beauty vary as well, and those are the things every other guide covers. The four above are the ones with numbers attached.
Which are the best places to live in Italy for healthcare?
Italy devolves health to the regions. The Ministry of Health scores each one on the Livelli Essenziali di Assistenza, the essential levels of care every region must provide. Each region gets a score from zero to 100 in three areas: prevention, community care and hospital care. A region has to reach 60 in every area separately. There is no averaging across them.
The Ministry publishes no overall score. The GIMBE Foundation, which monitors Italian health policy, produced one by adding the three areas together out of a possible 300. Its analysis of the 2024 monitoring was published on 23 September 2026.
| Region | GIMBE composite, out of 300 |
|---|---|
| Veneto | 288 |
| Emilia-Romagna | 282 |
| Tuscany | 280 |
| Piedmont | 272 |
| Trentino | 271 |
| Basilicata | 205 |
| Sicily | 196 |
| Molise | 192 |
| Calabria | 189 |
Seven of the top ten regions are northern, two are central, and one is southern: Puglia.
Three of twenty-one regions and autonomous provinces failed the threshold, down from eight in 2023. Calabria fell short on community care with 52. Sicily and the autonomous province of Bolzano fell short on prevention, with 49 and 59. Sicily’s 49 is the lowest score recorded in any single area anywhere in Italy.
GIMBE objects to how the scorecard works. Once a region clears 60 in all three areas it passes, and 60 counts the same as 100. In the same year the scorecard promoted eighteen regions, 5.8 million people in Italy went without prescribed care. The share skipping at least one appointment or test rose from 7.6% to 9.9%. A region can pass and still have queues.
Which regions are growing?
Italy’s population held level in 2025, at 58,943,000. Underneath that, the country divided.
| Area | Population change, 2025 |
|---|---|
| North | +2.2 per thousand |
| Centre | 0.0 |
| Mezzogiorno | minus 3.1 per thousand |
Istat’s projections widen the gap through 2050, with depopulation more pronounced in the South than in the Centre and North. That shows up in things a resident notices: school rolls, whether the local hospital keeps its maternity unit, how long a house takes to sell.
The national numbers and the projections to 2050 sit behind that regional split.
Where does the tax treatment change?
Less than the marketing suggests, with one exception.
The flat tax for new residents under Article 24-bis applies wherever in Italy a person becomes tax resident. It runs at €300,000 a year on foreign income, plus €50,000 per family member. Milan, Palermo or a hill town, the charge is the same.
The 7% regime for foreign pensioners under Article 24-ter is different. It applies only in eight southern regions, and only in municipalities under 30,000 residents. That ceiling rose from 20,000 in April 2026, bringing seventy-four more towns into range.
So the only regime that ties a tax break to a location ties it to the South. Those are the same regions scoring lowest on healthcare. Two of the eight, Sicily and Calabria, are the only southern regions that failed the standard outright.
What does property cost?
Immobiliare.it Insights put first-quarter 2026 averages at €5,645 per square metre in Milan, €4,733 in Florence, €3,802 in Bologna and €3,758 in Rome. The national average from the Agenzia delle Entrate’s OMI data sits near €1,130.
| City | Price per square metre |
|---|---|
| Milan | €5,645 |
| Florence | €4,733 |
| Bologna | €3,802 |
| Rome | €3,758 |
| National average | approximately €1,130 |
Sources differ on these figures because they measure different things: listings, completed sales, or the tax authority’s zone valuations. Treat any single number as an indication rather than a valuation, and check the OMI figures for a specific comune before committing.
The trade-off nobody mentions
Overlay the three datasets and a pattern appears that no charm-based ranking will show.
The regions with the strongest healthcare and the healthiest demographics are the expensive ones, in the North and Centre. The regions where a pensioner can pay 7% on worldwide income are the ones losing population fastest and scoring lowest on care.
That is not an argument against the South. It is an argument for choosing deliberately. A couple in their fifties in good health, spending part of the year in Italy, may reasonably weight the tax treatment heavily. A family planning to live there permanently, or anyone expecting to need consistent medical care, should weight the health scores instead.
Puglia is where the two considerations currently meet. It qualifies for the 7% regime and it is the only southern region in GIMBE’s top ten.
How to read this for your own situation
Start with the municipality rather than the region. Italy has around 7,900 comuni. The comune determines 7% eligibility, where residence is registered, which local health authority applies, and when the clock starts for permanent residence and citizenship.
Then check three things for the specific place. Its Istat resident population at 1 January of the year before any move. Its regional LEA standing. And the distance to the nearest hospital carrying the departments the household actually needs.
Then check the flight. Connectivity is the variable people underweight and regret most. A town three hours from an international airport is a different proposition in year five than it was on the viewing trip.
Residence itself comes before any of this. Italian residence routes and what the permit gives cover how a non-EU national reaches the point of choosing a town at all. Healthcare registration covers the cost of joining the system once there.
Frequently asked questions
What is the best region to live in Italy?
By healthcare performance, Veneto, Emilia-Romagna and Tuscany lead on GIMBE’s composite of the 2024 monitoring. By tax treatment for foreign pensioners, the eight southern regions in towns under 30,000. By population growth, the North. No single region wins all three.
Is southern Italy cheaper to live in?
Considerably, on property. Much of the South sits close to or below the €1,130 national average per square metre against €5,645 in Milan. The 7% regime for qualifying pensioners is also southern only. The trade-offs are healthcare scores and a shrinking local population.
Where do most foreigners settle in Italy?
The northern and central regions, which reflects employment, international schools and airport connections rather than any ranking of quality of life. Settlement patterns follow work and transport links more than climate.
Does where I live in Italy affect my tax?
Only for the 7% pensioner regime, which requires a qualifying southern municipality under 30,000 residents. The flat tax for new residents applies anywhere in Italy.
How good is Italian healthcare?
Life expectancy reached 81.7 years for men and 85.7 for women in 2025, second and third in the EU respectively. Regional performance varies widely, and 5.8 million people went without prescribed care in 2024.
Sources
- Ministry of Health, Livelli Essenziali di Assistenza monitoring for 2024, published July 2026
- GIMBE Foundation, analysis of the 2024 LEA monitoring, published 23 September 2026
- Istat, Indicatori demografici, Anno 2025, published 31 March 2026
- Agenzia delle Entrate, OMI property valuations, second half 2025
- Immobiliare.it Insights, first quarter 2026
Anyone weighing a specific location against a residence route is welcome to get in touch.