An earthquake measuring 3.6 magnitude hit the island of Ischia, off the coast of Naples, on Monday night, officials said, and first reports said one person was killed and at least 20 people injured in the collapse of several buildings.
Residents and tourists on the island, which is crowded at the height of the summer season, ran out on to the streets from homes and hospitals.
Television images showed that about six buildings in the town of Casamicciola as well as a church had collapsed in the quake, which hit at 8:57 p.m. (1857 GMT).
Roberto Allocca, a doctor from a local hospital, told Sky TG24 television that at least 20 people had been treated for minor injuries. Most of the hospital had been evacuated and the injured were treated outside. Media reports said one woman was killed when she was hit by falling rubble from a church.
Civil protection squads were already on the island because of brushfires and more were arriving from the mainland.
The television reports said the buildings that collapsed appeared to have been inhabited and a number of people were still unaccounted for.