Italy boasts an old tradition of power production from conventional hydro-geothermal resources. Today, over 25% of the energy consumed in Tuscany comes from these resources, albeit they are the exception rather than the rule. In Italy, as in most places of the world, there are numerous high geothermal gradient areas, often located in hot dry rock systems. Extracting such energy is rather difficult, and implies the creation of fractures or the opening of natural joints in reservoirs generally consisting of high-strength crystalline rocks. It is then necessary to inject cold water and to maintain the flow through the fractured network without water losses. These topics are studied in Italy too, with special focus on identifying the most suitable areas by assessing the underground temperatures and the severe environmental restrictions.