Silvio Berlusconi, then the Prime Minister of Italy, was accused and formally convicted of paying 17-year-old Moroccan Karima El Mahroug, also known by the stage name Ruby Rubacuori (Italian for "Ruby the Heartstealer"), for sexual services between February and May 2010 when she was under the age of 18; he was found not guilty on appeal. He was found not guilty on appeal also, formerly convicted of malfeasance in office (Italian: concussione) by arranging to have El Mahroug released from police detention during an incident in which she was briefly held on claims of theft. On 24 June 2013, the Court of First Instance sentenced Berlusconi to seven years in prison, and banned him from public office for life. Berlusconi appealed the sentence, and on 18 July 2014, an appeals court overturned Berlusconi's conviction, thus making him once again eligible to hold elected office.

The prime minister of Italy, officially the president of the Council of Ministers of the Italian Republic (Italian: Presidente del Consiglio dei ministri della Repubblica Italiana), commonly referred to in Italy as Presidente del Consiglio or informally as Premier, is the head of government of the Italian Republic. The office of prime minister is established by Articles 92 through 96 of the Constitution of Italy. The prime minister is appointed by the president of the Republic and must have the confidence of the Italian Parliament to stay in office.

Prior to the establishment of the Italian Republic, the position was called President of the Council of Ministers of the Kingdom of Italy (Presidente del Consiglio dei ministri del Regno d'Italia). From 1925 to 1943 during the Fascist regime, the position was transformed into the dictatorial position of Head of the Government, Prime Minister Secretary of State (Capo del Governo, Primo Ministro Segretario di Stato) held by Benito Mussolini, Duce of Fascism, who officially governed on the behalf of the King of Italy. King Victor Emmanuel III removed Mussolini from office in 1943 and the position was restored with Marshal Pietro Badoglio becoming Prime Minister in 1943. Alcide De Gasperi became the first prime minister of the Italian Republic in 1946.

The prime minister is the president of the Council of Ministers which holds executive power and the position is similar to those in most other parliamentary systems. The formal Italian order of precedence lists the office as being, ceremonially, the fourth-highest Italian state office.

Mario Draghi, former President of the European Central Bank, was appointed Prime Minister by President Sergio Mattarella on 13 February 2021 following the resignation of Giuseppe Conte.