This chapter examines the organisational landscape of elite civil society organisations in Italy at the national level, revealing a clear hierarchical structure dominated by a few top-tier organisations. These elite CSOs control the majority of resources and are primarily engaged in service provision, solidarity efforts, volunteering, and international aid, reflecting the broader orientation of the civil society sector. Two longstanding, broad-spectrum organisations stand out due to their historical significance, ideological roots, decision-making roles, public funding, and involvement in policy consultation. The next tier down includes influential networks representing the sector, major associations with national reach, Catholic service-oriented groups, and international organisations. A larger and more diverse group of CSOs focuses on narrower policy areas such as human rights, disability, international aid, solidarity/volunteering, and Catholic values, combining both service and advocacy roles. The ideological divide between Catholic and secular leftist groups remains prominent, echoing historical societal divisions. Elite organisations engage with various policy domains, integrating service provision with efforts towards systemic change. Their accumulation of economic and political resources creates a stratified organisational landscape, characterised by a distinct hierarchy.