In Italy several studies have examined the association between cancer and occupation in agricultural settings, focusing on exposure to pesticides. Most of the cohort studies evaluated cancer mortality in licensed pesticide users. Many case-control studies considered hematolymphopoietic malignancies, and the most recent studies observed increased risks for use of specific chemical classes of pesticides. Preliminary data on pesticide-related illnesses must be taken into account, and a national surveillance system should be implemented to identify areas at high risk and to promote exposure-control programs.