Italian business meetings can be disorganized, even spontaneous and they are mostly informal. Meetings are not meant to make business decisions, but to evaluate with colleagues and start new business relationships. It is important to be prepared for a long decision making process, because it is common to have more than one or two meetings before any decisions will be made. During the negotiating process patience is needed, it is not advisable to rush the process. Italians can be proficient English speakers, but it is always a good idea to have a translator present when negotiating.
If you are meant to give a presentation during a meeting, the audience will expect to discuss the content of the presentation and might even start talking while you are still presenting. If you are not flexible enough as their potential business partners, your presentation might get lost in the discussion, especially if the discussion is in Italian.
Plan the meeting carefully and create an agenda. Make sure to be on time and to invite the right people. It is important to make a good impression, just like many other countries. Bear in mind to gain respect, to be social and to be friendly. The Italians often use their lunch break for business meetings or business discussions, it is their way of establishing a business relationship. However, it is very rare to make decisions at mealtimes, it is allowed but it is seen as not appropriate to discuss a deal before the meal is finished.