Wales survived a major scare in the sunshine at Stadio Flaminio before keeping alive their RBS 6 Nations title hopes through a second successive away win.
As against Scotland at Murrayfield two weeks ago though, Wales only played in short bursts.
They posted first-half tries from wing Morgan Stoddart and flanker Sam Warburton, while recalled fly-half Stephen Jones kicked 11 points and centre James Hook landed a late drop-goal, but much of their performance was error-strewn and technically indisciplined.
Wales should have eased home after building a 21-11 interval lead, yet they lacked the tactical nous that would have enabled them to finish off a committed Italian outfit.
Centre Gonzalo Canale and skipper Sergio Parisse crossed for the home team, with Mirco Bergamasco slotting two penalties, but Italy missed four shots at goal, and a third defeat from three Six Nations starts this season suggests another wooden spoon beckons.
They responded well to a 59-13 drubbing against England last time out, testing Wales in the physical close-quarter combat and not being afraid to spin possession wide.
Wales ultimately had enough in the tank to prevent any repeat of Rome defeats in 2003 and 2007, but it was an encounter that will not live long in the memory.
And with Ireland and France looming on Wales' Six Nations agenda next month, they need a considerable improvement to challenge either of those teams.
The game began with a flurry of points, as both sides scored tries inside the opening 10 minutes.
Jones kicked Wales ahead through a short-range penalty, but the visitors' initial approach of trying to run everything backfired when they conceded a soft try.
Lock Bradley Davies threw out a poor pass on the edge of his 22 that went to ground, and Canale gathered, kicked ahead and beat a chasing Davies for the touchdown.
Italy's lead was a brief one though, as Wales launched another attack that ended with Stoddart crossing, although referee Wayne Barnes required confirmation from the television match official.
It was fast and furious, and after Bergamasco kicked a penalty to tie the scores, Wales responded with a second try.
Hook effortlessly unlocked the Azzurri's midfield defence and supporting Warburton had a simple task to finish off, with Jones' conversion giving Wales a 15-8 advantage after 14 minutes.
So open was the game, it resembled an end-of-season throw-about at times, although Wales had the comfort of knowing that two sustained attacks had resulted in two tries.
Italy thought they had cancelled Wales out on tries following a spell of sustained pressure that ended with flanker Alessandro Zanni diving over the line.
But Stoddart bravely got underneath him, and after another lengthy video referee adjudication, the decision went Wales' way.
Bergamasco then kicked a penalty, cutting the gap to four points, although that was the cue for Wales to attack again, launching several phases that tested Italy's defence.
There was no let-up in the tempo, but Wales were left kicking themselves when wing Shane Williams delivered a forward pass that denied full-back Lee Byrne his team's third try.
Italy, at times, were hanging on, yet Wales' technical indiscipline continued to irk Barnes as he awarded the Azzurri penalties at regular intervals.
But Italy were also not immune to infringing and Jones added two more three-pointers, taking Wales 21-11 ahead with the final scoring contributions of an often manic first half.
Bergamasco missed a straightforward penalty chance early in the second half, but they established a degree of territorial control that would have worried Wales coach Warren Gatland.
There was a flimsy method about Wales' approach at times, when they should have targeted a more direct route, and that played into Italian hands.
And the home side prospered when Wales were guilty of a comedy of errors, allowing Italy to win turnover ball, recycle possession and allow Parisse a try-scoring run.
Bergamasco failed with the touchline conversion attempt, but Italy were back in the hunt, 21-16 adrift as Wales continued to make hard work for themselves.
Hook's 72nd-minute drop-goal meant Wales could finally breathe with a degree of comfort, but there is much work to be done before the infinitely tougher challenge of facing Ireland in Cardiff on March 12.Reuse content