The occurrence of ochratoxin A (OTA), deoxynivalenol (DON), sterigmatocystin (STC), and citrinin (CIT) was evaluated in samples of small- (SS) and large-scale (LS) brewed beer. The analyses were conducted using HPLC-FLD for OTA, GC-MS for DON, and LC-MS/MS for STC and CIT. During 2017, a total of 83 samples of SS and LS brewed beer (42 and 41, respectively) were sampled; for both types of beer, the most sold beers in Italy were collected. CIT was never detected in any sample, whereas OTA, DON, and STC prevalence was 45.8%, 25.3%, and 27.7%, respectively. The mean and maximum values for OTA, DON, and STC were 0.007 and 0.070; 8.6 and 99; 0.001 and 0.018 µg/kg, respectively. No significant difference was observed between the SS and LS beers. The results of this survey showed a low contamination; the levels found should not represent a serious risk for consumers’ health.