Greig Laidlaw’s 79th-minute Scotland penalty denied Italy their first Six Nations victory since 2015 in Rome.
Tomasso Allan had booted Italy ahead in a dramatic final 10 minutes, before Laidlaw’s decisive strike.
Former Scotland Under-20 fly-half Allan contributed 22 points, including a try in either half, and also set up Matteo Minozzi to touch down.
Fraser Brown, John Barclay, Sean Maitland and Stuart Hogg scored for the Scots, who earned a try bonus point.
MAN OF THE MATCH: TOMMASO ALLAN
Previous results:
2018: Scotland won 29-27 in Rome
2017: Scotland won 34-13 in Singapore
2017: Scotland won 29-0 in Edinburgh
2016: Scotland won 36-20 in Rome
2015: Scotland won 48-7 in Edinburgh
2015: Scotland won 16-12 in Torino
2015: Italy won 22-19 in Edinburgh
2014: Scotland won 21-20 in Rome
2013: Scotland won 30-29 in Pretoria
2013: Scotland won 34-10 in Edinburgh
The teams:
Italy: 15 Matteo Minozzi, 14 Tommaso Benvenuti, 13 Giulio Bisegni, 12 Tommaso Castello, 11 Mattia Bellini, 10 Tommaso Allan, 9 Marcello Violi, 8 Sergio Parisse, 7 Jake Polledri, 6 Sebastian Negri, 5 Dean Budd, 4 Alessandro Zanni, 3 Simone Ferrari, 2 Leonardo Ghiraldini, 1 Andrea Lovotti
Replacements: 16 Oliviero Fabiani, 17 Nicola Quaglio, 18 Tiziani Pasquali, 19 Abraham Steyn, 20 Giovanni Licata, 21 Guglielmo Palazzani, 22 Carlo Canna, 23 Jayden Hayward
Scotland: 15 Stuart Hogg, 14 Tommy Seymour, 13 Huw Jones, 12 Nick Grigg, 11 Sean Maitland, 10 Finn Russell, 9 Greig Laidlaw, 8 Ryan Wilson, 7 Hamish Watson, 6 John Barclay (c), 5 Jonny Gray, 4 Tim Swinson, 3 WP Nel, 2 Fraser Brown, 1 Gordon Reid
Replacements: 16 Stuart McInally, 17 Jamie Bhatti, 18 Zander Fagerson, 19 Richie Gray, 20 David Denton, 21 Ali Price, 22 Pete Horne, 23 Blair Kinghorn
Date: Saturday, March 17
Venue: Stadio Olimpico, Rome
Kick-off: 13:30 local (12:30 GMT)
Referee: Pascal Gaüzère (France)
Assistant referees: Jérôme Garcès (France), Andrew Brace (Ireland)
TMO: Marius Jonker (South Africa)