Hospital catering is very important to counteract the onset of malnutrition due to either undernutrition or overnutrition and for dietetic treatment. The aim of the study was to evaluate nutritional quality of the hospital dietetic manual used in some Italian hospitals and to analyze the role of the institutional Catering Service and of the Department of Clinical Nutrition. A survey has been carried out, in some Italian hospitals, using a questionnaire to point out the characteristics of hospitals, the typology of catering service, of the diets and of the staff of the Department of Clinical Nutrition. Only 22% of the hospitals has answered; three Italian regions (Umbria, Molise, Basilicata) are completely missing; -each hospital has a specific dietetic manual in most cases completely different from structure and nutritional quality point of view; the staff acting in this field is absolutely insufficient in term of numerousness and of professional typologies. Hospital in-patients are not homogeneous as for age, dietary needs and diseases, so it's necessary to treat them with an ad hoc nutritional intervention not established in advance in a dietetic manual; if from an organisation point of view it is necessary to have such a dietetic manual, it has to be based on nutritional guidelines and recommended dietary allowances.