Both sides failed with late drop-goal attempts, as the two Group C rivals remain unbeaten in the tournament so far.
Ben Hellewell’s second try of the game in the 70th minute levelled the scores, after Italy had taken the lead for the first time ten minutes earlier.
It was the Azzurri who shaded the opening exchanges at Derwent Park, but it was the Scots who were first on the scoreboard after a 14th minute penalty from Danny Brough.
Seven minutes later the electric Matthew Russell was then rewarded for a great show of speed and strength, as video referee Thierry Alibert gave the all-clear for the full-back’s third try of the tournament.
The Bravehearts were soon further in front, as from kick-off Peter Wallace kicked a 40-20. Brough then used his boot and opposing winger Josh Mantellato was unable to collect the grubber, allowing Kane Linnett to pick up and score.
Italy reacted well though, and were soon back in the game.
In the 32nd minute, after previously being held up over the try-line, Cameron Ciraldo got Carlo Napolitano’s men on the scoreboard by athletically picking up a Ryan Ghietti grubber to score.
There was soon more pressure on the Scotland defence and it finally told just before half-time, as replacement hooker Raymond Nasso found a gap from dummy-half to score.
The fast-paced action did not abate in the second period, and there was a try for each team in the opening five minutes of the half.
Right winger Carter then assisted another try in the 50th minute, as he motored down the touchline before feeding Hellewell.
The try-for-try pattern continued as the Italians closed the gap once more in the 54th minute.
Five minutes later the Azzurri took the lead for first time, as a James Tedesco kick ricocheted to captain Anthony Minichiello for a simple finish.
As they did against Tonga, Steve McCormack’s side had the character to fight back, and they did so in some style.
A moment of magic from Brough was the catalyst, as his chip and chase was followed by flowing hands to put Hellewell in for a sublime team try.
Brough missed his first conversion of the match to leave the scores level, and then in the dying moments the Huddersfield playmaker also saw a drop-goal attempt thwarted.
This left Italy with a chance for their own one-pointer on the stroke of the final hooter, but a mix up led to a desperate miss from out wide.
Scotland: 1. Matthew Russell, 2. Alex Hurst, 3. Ben Hellewell, 4. Kane Linnett, 5. Brett Carter, 6. Danny Brough, 7. Peter Wallace, 8. Adam Walker, 9. Ian Henderson, 10. Luke Douglas, 11. Danny Addy, 12. Dale Ferguson, 13. Ben Kavanagh. Interchanges: 14. Ben Fisher, 15. Brett Phillips, 16. Mitchell Stringer, 17. Oliver Wilkes.
Italy: 1. Anthony Minichiello, 2. Joshua Mantellato, 3. James Tedesco, 4. Aidan Guerra, 5. Chris Centrone, 6. Ben Falcone, 7. Ryan Ghietti, 8. Anthony Laffranchi, 9. Dean Parata, 10. Paul Vaughan, 11. Mark Minichiello, 12. Cameron Ciraldo, 13. Joel Riethmuller. Interchanges: 14. Kade Snowden, 15. Ryan Tramonte, 16. Brendan Santi, 17. Raymond Nasso.
Referee: Henry Perenara.
Venue: Derwent Park, Workington.