I have lived full time in Italy for a few years now, and while I’m happiest in the tranquil Umbrian countryside—where slow living among centenarians and farmers feels like stepping into a romantic film—I can still appreciate the advantages that come with city life.

Now, a new report has been released focusing on Italy’s most desirable places to live, and all are concentrated in the north. The Quality of Life in Italy report from ItaliaOggi, in collaboration with Rome’s La Sapienza University, is now in its 27th edition and is an annual survey offering a snapshot of social wellbeing, economic vitality, and lifestyle excellence.

While you would think a life on the Amalfi Coast or under the Tuscan Sun would rank high for quality of life, other deciding factors are in play.

This year, Milan secures its position at the top of the national rankings, confirming its status as Italy’s most dynamic and future-focused destination. According to the report, the country’s fashion and finance capital performs well across eight of the report’s nine evaluated categories including public services, business environment, culture, tourism, healthcare, and education. The one exception is crime and security, where Milan remains Italy’s weakest performer this year.

Following Milan, the Alpine province of Bolzano claims second place, known for its stunning landscapes, bilingual cultures, exceptionally high standards of public services, and high levels of wellbeing. In third place is Bologna, the elegant, foodie capital of Emilia-Romagna, best known for quality universities and a booming economy.

Other high performers in the report include:

  • Florence (4th) – Best known as Tuscany’s iconic Renaissance destination, it has a thriving tourism and cultural life.
  • Monza (5th) – A polished, affluent city benefiting from its proximity to Milan.
  • Trento (6th) – A model of sustainability and mountain living.
  • Padua (7th) – A historic university city with a strong scientific and cultural identity.
  • Verona (8th) – The romantic Veneto gem, supported by tourism and a busy service sector.
  • Parma (9th) – A gastronomic capital with exceptional quality of life statistics.
  • Reggio Emilia (10th) – A balanced city known for education and family-friendly innovation.

In contrast, one of my favorite places in the world, Rome sees a surprising setback, dropping five places to the 29th position, after several years of delayed jubilee improvements. The capital continues to struggle with issues of infrastructure, services, and urban management.

Once again, Southern Italy finds itself at the bottom of the list. Caltanissetta ranks last among Italy’s 107 provinces, followed by Crotone and Reggio Calabria, with Naples landing in 98th place.

Yet the overall picture is far from bleak. The new report highlights noteworthy areas of growth in the South, particularly in medium-sized cities that are showing resilience and renewal. Bright spots include:

  • Lecce – A sun-drenched baroque city, busy with tourism and improving services.
  • Cagliari – Sardinia’s coastal capital, where the quality of urban life is rising to match central Italian standards.
  • Bari, Potenza, and Campobasso – These Provinces hold steady thanks to better healthcare and infrastructural improvements.

The report notes that healthcare had the most substantial impact on the new results. Virtually every province saw an increase in health-related scores, with an average gain of more that 150 points. Available hospital beds, waiting times, and proximity to service all showed progress, even in regions traditionally considered weaker.

Italy’s recent economic slowdown, rising living costs, and inflation have squeezed urban areas and middle-class households. Milan, Bologna, and Florence still have some of the country’s highest incomes yet are scored lower than before in perceived economic well-being. Bolzano maintains its strong position, while Padua climbs into the top 20. Tourism-dependent economies including Rimini, Verona, and Florence, show increased volatility, reflecting seasonal fluctuations and softer domestic spending.

Even with these challenges, Italy seems to be settling into a more stable phase. After years of ups and downs, from the recession to the pandemic, the gap between regions is finally starting to shrink, even if it’s happening little by little.

MORE FROM FORBES

best places to live in Italy