Mafia 'boss of bosses' Salvatore 'Toto' Riina has died while serving multiple life sentences, according to Italian media.
The justice ministry on Thursday had allowed his family a bedside visit at a hospital in Parma shortly before his death. The reports said he died aged 87 on Friday morning but the government had no immediate comment.
He had been placed in a medically induced coma after his health deteriorated following two recent surgeries.
Riina, one of Sicily's most notorious Mafia bosses, was serving 26 life sentences for murder convictions as a powerful Cosa Nostra boss.
He was captured in Palermo, Sicily's capital, in 1993 and imprisoned under a law that requires strict security for top mobsters, including isolation in prison and limited time outside their cells.
Prosecutors accused Riina of masterminding a strategy, carried out over several years, to assassinate Italian prosecutors, police officials and others who were going after Cosa Nostra.
The bloodbath campaign ultimately backfired on Cosa Nostra, as after bombs killed Italy's two leading anti-Mafia magistrates, Giovanni Falcone and Paolo Borsellino, two months apart in 1992, the state stepped up its crackdown on Sicily's Mafiosi.
Riina was captured in a Palermo flat six months after Mr Borsellino and his police escorts were killed by a car bomb.
A native of Corleone, a Sicilian hill and Mafia stronghold, he steadfastly refused to collaborate with law enforcement after his capture.
Riina was incarcerated at a Milan prison before he was admitted to hospital.
In July, a court denied a request by Riina's family to transfer the convicted mobster to house arrest because of his ailing health.