Italy 0 Sweden 0 (Sweden win 1-0 on aggregate)
Italy have failed to qualify for the World Cup for the first time since 1958 after being shut out by Sweden at a sold-out San Siro.
Trailing 1-0 on aggregate to a Jakob Johansson goal scored in Friday's first leg in Stockholm, Giampiero Ventura's Azzurri were cheered on by almost 72,000 Italian fans in Milan.
But despite laying siege to the Scandinavian defence over 90 feverish minutes, Italy could not make the breakthrough and the goalless draw was enough for Sweden to reach Russia 2018.
Head coach Ventura, who in August agreed a new contract running until 2020, has borne the brunt of the criticism across a World Cup campaign which saw four-time world champions Italy limp to a second-place finish behind Spain, and with that the ignominy of a two-legged play-off.
It was always going to be hard for Italy to get their own way in the Swedish capital, but with a wealth of striking options, one of the stingiest defences in Europe and arguably the best goalkeeper in the world in Gianluigi Buffon, much more was expected from this return clash.
Buffon may be hardest hit by Italy's failure to reach the summer finals. At 39, the Juventus stopper had already decided to quit international football after the tournament and his 175th cap, won on a dismal night in Milan, may be his last.
The increasingly execrated Ventura yielded to the incessant calls to use Napoli pass-master Jorginho in midfielder by handing the Brazil-born player a first competitive Italy cap.
Manolo Gabbiadini got the nod - perhaps surprisingly ahead of Lorenzo Insigne - to lead the line alongside Lazio striker Ciro Immobile.
The Southampton player was first to test the Swedes' resolve, finding his shot blocked before Manchester United's Matteo Darmian, deployed on the left wing, blasted wide of goal.
Jorginho soon released Immobile down the right and Robin Olsen had to make a smart stop amid steadily building Italian pressure.
Retaining control, the Azzurri grew in confidence after the half hour and Antonio Candreva came close to scoring when rifling Immobile's low cross towards the top of the net, where Olsen blocked.
Andreas Granqvist was Sweden's saviour as half-time drew nearer.
First he scooped Immobile's goalbound effort off the line before tidying up when Marco Parolo looked like turning home a Darmian pass.
He and his fellow centre-back Victor Lindelof were lucky, though, when Alessandro Florenzi missed the mark when cutting inside from the left byline.
After the break Darmian had a penalty shout rejected after controlling Florenzi's cross - Spanish referee Antonio Mateu Lahoz instead called handball.
Florenzi's next attempt struck the far post and following another turn of the screw Immobile was left with his head in his hands after side-footing Candreva's wicked cross wide from close range.
Olsen got underneath a looping ball - a deflected Florenzi strike - that threatened to drop in at his far post and from then on Italy's high-intensity approach abated somewhat.
It was not until the 77th minute that the Azzurri threatened again, Florenzi blasting high from a pinpoint winger's cross by defensive stalwart Giorgio Chiellini.
Olsen faced a few desperate moments as time ticked away in west Milan.
The FC Copenhagen keeper parried a bullet header from Parolo and with three minutes remaining, punched substitute Stephan El Shaarawy's powerful drive to safety.
It was enough for Sweden, who will play at the finals for the first time since 2006 - the same year in which Italy were last crowned champions of the world.