The aim of this paper is to analyze agricultural risk management based on insurance schemes in Italy to evaluate the efficiency of risk management strategies. The Italian agricultural insurance market in the last decade has been characterized by a systemic shift from a public system to a highly subsidized “Public Private Partnerships System”, and by a development of combined risk/multiple perils contracts. Public spending is significantly high, but the market penetration is low, and the demand is concentrated in Northern Italy and focused on some specific crops. The approach appears inefficient in facing the farms’ risk and in public funds allocation, too focalized on insurance schemes, not sufficiently diversified and not able to remove the causes that hinder the creation of an insurance market. The research should be developed in the future with more quantitative analysis focused on some specific aspects to confirm our findings, such as adverse selection, moral hazard, systemic risk and, over all, farmers’ willingness to pay for insurance contracts. The current Italian agricultural risk management policy is too expensive and does not really reflect needs and conditions of farms. The public intervention sustains farms with limited needs for financial support and does not encourage development of a private insurance market. The research can contribute to stimulate a scientific and politics debate. The study provides a critical overview of the Italian situation.