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The isonymy structure of Italy was studied using the surname distribution of 5,043,580 private telephone users selected from a 1996 commercial CD-ROM that contains all 24 million users in the country. The users were distributed in 123 towns selected on a geographic basis. The 123 towns were either on the main communication roads of the country or at the ends of such roads. The shortest distance between nearest neighbor towns was 5.3 km (Carrara and Massa), and the largest distance was 1,136 km (Aosta and Castrignano del Capo). The number of different surnames found in the whole analysis was 215,623. Lasker’s distance, the negative value of the logarithm of random isonymy between localities, was linearly and significantly correlated with the logarithm of geographic distance, with r = 0.63 ± 0.008. A dendrogram was built from the matrix of isonymy distances, using UPGMA. It separates the Italian towns into 5 main clusters: 1 in the southern portion of the country, a second cluster toward the center, and 3 in the northern area of Italy. Within each cluster small subclusters with specific geographic distributions could be related to regional borders. Comparisons with the results of a previous analysis of Switzerland and Germany’s structures are given. From the present analysis isolation by distance emerges clearly, although it is less strong than in Switzerland and stronger than in Germany. The random component of inbreeding estimated from isonymy indicates that the southern area of Italy is on average more inbred than the northern area. In fact, the heterogeneity is greater in the northern area, particularly in the plain of the Po River, than anywhere else in Italy.