Given our country’s geographical structure and history, it is not surprising that the Italian port system features a wide variety in terms of infrastructure, volumes, commercial activities, efficiency, and development. However, since the 1980s the absence of a view to development of the ports, which is instrumental to the development of the country, has limited its prospects for growth, relegating the country’s port system to a local and often secondary role, in comparison with other European ports. The reforms introduced in the early 1990s and in the last five years, through the institutional reorganization of the port authorities into Port System Authorities (AdSPs), have enabled greater flexibility in the definition of port strategies, even though the entire system has not yet succeeded in achieving its potential because of infrastructure delays and the difficulty for some ports in finding alternative uses demanded by the macroeconomic context. Much also remains to be done in terms of land connections, in particular with railway facilities.