England were left frustrated by a resurgent Italian performance as the hosts kept their Grand Slam hopes alive with an 18-11 win.
Six penalties from Toby Flood kept England ahead on the scoreboard as Italy recovered from a 15-3 deficit at the start of the second half to leave Twickenham on edge in a dramatic finish.
The Azzurri resembled the side that were so impressive in their opening game of the championship against France - hounding England in defence and creating ample attacking opportunities in the second half against an opponent who they have never defeated.
Only desperate defence from England going into the final 10 minutes kept the hosts clinging on to the lead, with all thoughts of a first Grand Slam in a decade put firmly on hold.
England signalled their intent early on with a penalty from Toby Flood after just three minutes - the Leicester fly-half coming in for the injured Owen Farrell.
Mike Brown came close to the opening try after Luciano Orquera's kick was charged down, but the ball eluded him as he tried to make the grounding.
The hosts enjoyed all the possession throughout the opening minutes but were unable to find the opening try, Flood settling for another three points to leave England 6-0 up after 15 minutes.
Italy responded on their first visit to England's half with a penalty from Orquera after an effective driving maul, lifting the voices of the visiting fans. The Azzurri supporters grew even louder minutes later when Alessandro Zanni burst down the left touchline after Sergio Parisse's inside flick - only for the ball to be knocked on.
England's large swathes of possession created another try-scoring opportunity for the hosts, but Flood's attempted score was ruled out. Italy then lost scrum-half Edoardo Gori to the sin-bin for taking out Flood off the ball.
The hosts' power at the scrum was again capitalised on by Flood, who added a further three more points after a fine break from Brown to leave England 12-3 up going into the interval after a frustrating half for the home fans.
Another Flood penalty at the start of the second half extended the gap and left Italy chasing the scoreboard, Orquera responding with a penalty of his own after England collapsed at the scrum.
Care's sloppy box kick was then taken out of the air by Andrea Masi and Orquera's delicate chip across to the left wing was snapped up by Luke McLean to score in the corner.
Giovambattista Venditti then carried down the right touchline to leave English tacklers on the deck, but Orquera's resultant penalty attempt fell well wide to the right - failing to make the most of a passage of play where England lost control.
The introduction of Ben Youngs steadied Flood and England crept back to a seven-point advantage thanks to another penalty from the Leicester number 10.
Italy however continued to produce some of their best rugby in this year's championship, finding space down the left-hand side through McLean.
It meant that England were clinging on desperately to their lead as time ticked away, until a knock-on five metres from their own try line led to a collective sigh of relief from the 82,000 crowd.
Twickenham expected a thrashing - the humbled crowd left booing and counting their blessings.
Man of the Match: A whole host of Italian candidates to choose from in defeat, with Alessandro Zanni getting the nod ahead of his captain Parisse, Masi and winger McLean.
Moment of the Match: Courtney Lawes' crucial line-out steal with two minutes remaining that helped England ease the Italian pressure.
Villain of the Match: Starting his first Test for some time, Toby Flood may have kicked well off the tee but struggled to get England's backs firing.
Pens: Flood 6
Pens: Orquera 2
Yellow Card: Gori
England: 15 Alex Goode, 14 Chris Ashton, 13 Manu Tuilagi, 12 Brad Barritt, 11 Mike Brown, 10 Toby Flood, 9 Danny Care, 8 Tom Wood, 7 Chris Robshaw (c), 6 James Haskell, 5 Geoff Parling, 4 Joe Launchbury, 3 Dan Cole, 2 Tom Youngs, 1 Mako Vunipola.
Replacements: 16 Dylan Hartley, 17 David Wilson, 18 Joe Marler, 19 Courtney Lawes, 20 Tom Croft, 21 Ben Youngs, 22 Freddie Burns, 23 Billy Twelvetrees.
Italy: 15 Andrea Masi, 14 Giovambattista Venditti, 13 Gonzalo Canale, 12 Gonzalo Garcia, 11 Luke McLean, 10 Luciano Orquera, 9 Edoardo Gori, 8 Sergio Parisse, 7 Robert Barbieri, 6 Alessandro Zanni, 5 Joshua Furno, 4 Quintin Geldenhuys, 3 Martin Castrogiovanni, 2 Leonardo Ghiraldini (c) 1 Alberto De Marchi.
Replacements: 16 Davide Giazzon, 17 Andrea Lo Cicero, 18 Lorenzo Cittadini, 19 Antonio Pavanello, 20 Francesco Minto, 21 Simone Favaro, 22 Tobias Botes, 23Tommaso Benvenuti.
Referee: George Clancy (Ireland)
Assistant referees: Nigel Owens (Wales), Mathieu Raynal (France)
Television match official: Simon McDowell (Ireland)
By Ben Coles