The largest part of Italian economic activity is in the hands of small and medium-sized enterprises, frequently managed by entrepreneurs and their families. The importance of the Italian entrepreneurial landscape makes it a relevant topic of study but the Italian case is also valuable to inform international entrepreneurship and small business studies for other reasons: Italy is characterized by traditional or specialization industries and firms that have achieved international competitiveness notwithstanding the prevailing small scale of their businesses. At the same time, the foreign growth potential of many small businesses has not been exploited yet. A second specificity is represented by the frequent concentration of economic activities, especially of smaller firms, in districts and local clusters. This spatial organization – nationally and internationally – of economic activities in Italy provides an interesting perspective about how SMEs cope with the liability of smallness and with problems related to institutional voids, a third condition that is in contrast with other main European economies. This work builds on a rich body of literature, from scientific works to statistical surveys, which is mostly unknown outside Italy. A primary objective of our research is to unveil this literature and help to discover specificities of Italian international SMEs, as well as commonalities with similar firms in other countries. Second, we aim at discussing critically this body of research, by comparing different Italian findings and by confronting them with the international literature, in order to elaborate some research propositions, which may be extensible to SMEs internationalization issues in different contexts.