The paper focuses on the models and practices of regional spatial planning activated in Italy in recent years, in order to evidence the innovations that occurred and challenges that Regional planning institutions are facing. Just after the devolution of local power in Italy in 1977, spatial planning competences began being organized into Regional Institutions. Each of the twenty new Regions must make a Territorial Regional Plan (Piano territoriale regionale) together with a Regional Landscape Plan (Piano paesaggistico), possibly in connection with a Development Regional Program (Programma regionale di sviluppo).