In the forty years since the establishment of regional governments in Italy, the system of regional and local autonomy has undergone profound changes. Regions, together with local governments, have been integrated into a different system of public powers, both national and supranational, in which the preeminent role of the State as "the sole hinge of administrative law" has reduced. This essay investigates these transformations, questioning whether legal changes have led to the actual configuration of regional and local orders and of their relationships with the State. It analyses problems and tensions still not solved by such developments. The article is divided into four parts. The first briefly analyses the events that separate the ratification of the Constitution of 1948 from the establishment of the regions by legal statute. The second examines the first twenty years of regional experience (1970-1990). The third part looks at the great constitutional and administrative reforms of the 1990s, while the fourth part gives final remarks on the issue examined.