Matteo Politano came off the bench to snatch a late winner for Italy, breaking the deadlock in the 94th minute against United States.
Roberto Mancini's side toiled for much of Tuesday's international friendly in Genk but finally found a way to beat impressive goalkeeper Ethan Horvath with mere seconds remaining in added time.
Politano only came on as a substitute with three minutes to play but he dashed into the box to finish sweetly at the end of a rare incisive attack from the Azzurri.
Italy have now kept three clean sheets in a row but Mancini will be concerned about how long it took his team to break down an inexperienced United States side.
Horvath denied Federico Chiesa in the third minute, the Fiorentina forward then rifling wide of the far post.
In a lively start for the Azzurri, the busy Horvath blocked a Leonardo Bonucci effort after the centre-back was picked out by a clever free-kick from debutant Stefano Sensi.
Horvath tipped over a dipping 20-yard curler from Domenico Berardi in the 39th minute and had to be alert to push away Marco Verratti's inswinging free-kick as Italy kept pushing for the opener.
Half-time substitute Vincenzo Grifo delivered a chipped cross that Verratti could not quite jump high enough to convert as the onslaught continued after the interval.
United States, for whom Christian Pulisic became their youngest captain of the modern era, finally recorded a shot in the 63rd minute when Kellyn Acosta's free-kick found Walker Zimmerman at the back post, but Salvatore Sirigu palmed the defender's header away.
Grifo forced yet another save from Horvath and teenage striker Moise Kean dragged a decent chance wide on his debut as Italy grew increasingly desperate.
But in the last minute of added time, Verratti fed Roberto Gagliardini and the Inter midfielder laid off a clever pass for the onrushing Politano to collect and beat the unfortunate Horvath.
It is seven games in a row under Mancini without a goal in the first half for Italy and their lack of a clinical edge in front of goal was clear to see. Plenty of chances were created and Horvath had a lot to do, but not many of his saves were particularly challenging to pull off. It took Inter team-mates Politano and Gagliardini, both late substitutes, to unlock the US defence.
Horvath repels Azzurri attack
United States were grateful for goalkeeper Horvath, the 23-year-old keeping Italy at bay almost single-handedly. He was perhaps fortunate Italy's finishing was so poor until Politano's late impact, but the Club Brugge goalkeeper showed excellent reflexes. He did not deserve to be on the losing side.
Berardi and Chiesa lacklustre
Italy have lacked an elite striker for some time and on this evidence, neither Berardi nor Chiesa have the quality required to score regularly at international level. Their work outside the box was adequate but when the chances came they failed to make the most of the opportunities.
Focus turns to domestic duties as the next international break is not until March.