In 1998, the National Health Plan identified the reduction of hospital infection (HI) incidence as a priority. This article reviews the main activities set up in Italy on infection control in the hospital setting. In 1983, the first national prevalence survey reported 6.8% and 7.6% prevalence rates of patients with HI and of HIs, respectively. The high point prevalence found in the intensive care units (ICU) (12.5%), prompted a national incidence study in 1985. This study found an incidence of 29.5 HIs per 100 patients in the ICUs: lower respiratory tract infections (LRTI) were the most common HIs (47.8%), followed by urinary tract infections (UTI) (19.9%) and blood stream infections (BSI) (4.8%). A 1999 survey showed that in 463 Italian hospitals only 40.5% had protocols on the use of disinfectants, 32.3% on sterilization, 30.8% on occupational risk management, 18.3% on isolation measures, 17.7% on hand-washing, 14.3% on antibiotic prophylaxis in surgery, 9.4% on the prevention of surgical site infections and 8.5% on the management of CVC. A national forum to consider surveillance systems using standardized definitions and methodologies is urgently needed.