The aim of the present work is to assess mortality associated to extreme meteorological and hydrological events (storms, floods, landslides, avalanches) for the period 2003–2020 in Italy. These extreme events are particularly worrying phenomena due to their increasing frequency and intensity connected to climate change. The considerable rise of extreme meteorological events in Italy has been having a dramatic impact on the environment and territories, particularly on intrinsically fragile ones, and on resident populations. More than 90% of Italian municipalities are at risk for extreme events, with more than 8 million inhabitants exposed. Number of deaths and SMRates due to such extreme events (X International Classification of Diseases: X36, X37 and X38) in Italy were calculated from regional to municipal level by ENEA mortality database (data source ISTAT). Geographic maps were elaborated by QGIS software (QGIS, RRID:SCR_018507) version 3.28. In the selected period, 378 overall deaths were detected: 321 deaths due to landslides and avalanches, 28 to cataclysmic storm, and 29 to floods. The regions with the highest mortality levels and/or number of municipalities involved and the municipalities at highest risk were identified. In consideration of the forecasted increase of such extreme events in Italy, the knowledge of Italian areas at highest risk can be used in the decision-making processes to assess priorities, allocate financial resources, define warning measures, and undertake preventive or mitigation actions. Moreover, the attributable mortality levels can be a useful basis for further risk assessment research aimed at estimating the cost in terms of human lives’ loss associated to such events in future climatic scenarios. © The Author(s) 2024.

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