International research in school psychology has suggested that Italy is among the remaining nations that have not generated systematic inquiry to clarify the practice of psychology in its schools. Italian school psychology has long been presumed to be nonexistent due to historical factors hindering its development and lack of local research readily available to a wider readership. The purpose of this study was to contribute to the growing knowledge base of Italian school psychology by presenting the findings of the first systematic nationwide research initiative targeted to gain an understanding of the profession. Surveys were collected from 1,251 schools and 690 school psychologists as respondents to obtain their perceptions of the profession. Characteristics, interface between the school and psychologist, professional practice, evaluation of professional practice and professional perceptions are discussed. Findings from this research initiative suggest that school psychology in Italy has followed a distinct evolution which has developed thus far into refined forms of consultation that are strongly correlated with relational ties between school psychologists and their schools. Implications for the training needs of school psychologists, the changing trends of interventions and areas of subsequent research are discussed.