The importance of the 2016 municipal elections in Italy was a consequence not only of the number and relevance of the cities involved, including Rome, Milan, Naples, and Turin, but also of their timing, occurring in the middle of the 2013–2018 electoral cycle. These elections were thus perceived as a mid-term test for the national government, acquiring a relevance that went beyond their specific local context. This chapter analyzes the electoral supply, voter turnout, electoral results, and vote shifts, focusing on a synchronic and diachronic comparison of the performance of the candidates and the parties. The evidence presented shows that despite winning the plurality of municipalities, the Democratic Party clearly paid the cost of ruling at the national level. The number of its mayors was halved, and it was defeated in Rome and Turin by the Five Star Movement, the true winner of these elections.