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Summary Aim To determine the prevalence (cases per million inhabitants) of home artificial nutrition (HAN), enteral (HEN) and parenteral (HPN), in Italy, grouped according to administrative regions, patient age and primary disease, and to analyze the impact both of the presence of an HAN regional regulation and of demographic characteristics. Methods In April 2005, the Regional Coordinators of the Italian Society for Parenteral and Enteral Nutrition (SINPE) recorded all the ongoing cases of HAN using a structured questionnaire and were asked to estimate the representativeness of the collected sample with respect to the total expected HAN. Results A total of 6955 cases of HAN (93.5% adults, 6.5% pediatric patients ⩽18 years) were recorded in 16 of the 20 Italian regions (80% of the Italian population; sample representativeness 78%). HAN prevalence 152.6 (83.9% HEN, 16.1% HPN); the HAN range among the regions was: prevalence 28.1–519.8; oncological disease 13.8–75.7%, neurological disease 15.5–79.9%, intestinal failure 1.3–14.0%. An HAN regulation was present in 11 regions. A positive association ( P = 0.012 ) was found between the number of years since the regulation was issued and the HAN prevalence, and also between the % neurological patients and the population density ( P = 0.130 ) and the % inhabitants ⩾75 years ( P = 0.040 ). Conclusions The need for HAN regards a great number of patients throughout the country; there are substantial differences between the regions with respect to both the prevalence and the use of HAN in various disease categories. A specific regulation may favor the development of HAN.