Italy, together with Japan, is among the oldest countries in the world. At European level, the country has the highest old-age dependency ratio (+4.5 percentage points compared to the EU average) and the lowest birth rate (-2.3 percentage points compared to the EU average). This is what emerges from the study 'Rinascita Italia' released on the occasion of the Ambrosetti forum in Cernobbio. Considering a mortality rate destined to increase, Istat estimates tell us that the combined effect of these trends will further reduce the Italian population by 2050 compared to about 59 million inhabitants today (51.1 million inhabitants in the worst scenario, 54.2 million inhabitants in the median scenario, 57.5 million inhabitants in the best scenario). It is clear that this scenario is destined to have repercussions both at the level of the country-system and of generational balance. In a dystopian scenario, other things being equal and projecting the current twenty-year trend of mortality and birth rate, the last Italian on earth could be born in just over 200 years and die in about 300. But, beyond the provocations, it is clear that a population that decreases triggers in the long run problems of sustainability, primarily work, pensions and health care. In this regard, the ratio between pensioners and workers by 2050 is estimated at 1 to 1, with obvious implications on the pension deficit and the increase in the working age to support it (estimated to break through 70 years).