Silvio Berlusconi was criticised for again calling Barack Obama "suntanned" and extending the insult to his wife, Michelle.
At a rally last night Berlusconi said: "I have to bring you some greetings, greetings from a man, what is his name, what is his name - just a minute it was someone with a tan - Barack Obama".
He then added: "You won't believe it but they went together to the beach to get a tan because even his wife is suntanned."
Berlusconi had just returned from the G20 summit in Pittsburg where he met the Obamas and Italian newspapers noted that Michelle Obama only shook his hand while she kissed other leaders.
L'Unita, the newspaper of the main opposition party, the Democratic Party, put the comments on its front page with a photograph of Michelle Obama.
"He makes us look ridiculous before the whole world," the newspaper said, adding that the comment was "a racist gaffe". The left-leaning La Repubblica said it was a "reckless comment".
Berlusconi was also criticised by Italy's only black parliamentarian Jean Leonard Touadi, who is of Congolese origin.
"By repeating these quips that are out of place, the prime minister continues to damage the image of Italy," he told the Italian news agency from Washington, where he was meeting black members of the US Congress.
Berlusconi first got into hot water over Obama last November when, during a trip to Moscow, he called the then president-elect "handsome, young suntanned".
The next day in Brussels, when an American reporter asked whether he would apologise to Obama, the prime minister told the reporter he was worthy of a place on his list of "imbeciles".
Berlusconi is no stranger to gaffes and controversial comments. In 2003 he likened a German member of the European Parliament to a Nazi camp guard and in 2005 he suggested that he had wooed Finnish President Tarja Halonen to ensure her backing for Italy to host the European Food Safety Authority.