This chapter examines the elite structure of Italian civil society, tracing its historical roots in the Catholic Church and socialist movements, and how it mirrors broader national elite patterns and societal inequalities. It tracks the third sector’s development from its political party origins to its expansion and institutionalisation in the 1990s, following the collapse of the post-war system. The analysis covers the sector’s evolving relationship with the state, from fragmented pluralism to a “golden age” of institutionalisation, followed by de-institutionalisation and then the recent re-institutionalisation marked by the 2017 reform. Current challenges include public mistrust, the rise of new conservative actors, and conflicts with populist governments over shrinking civic space. Insights are provided into the formation of the third-sector elite, its characteristics, and the societal forces shaping its role. The chapter explores how political developments, especially the rise of populist actors, have impacted upon state–civil society relations and the third-sector elite, and how this has led to de-legitimation processes and power shifts within the civic sphere. It underscores the interdependence between civil society’s leadership and the broader Italian elite, reflecting broader societal dynamics and shifts.