Italiano was elected to the state senate in 1967 to the newly created 3rd district. Italiano was a supporter of the League of Women Voters during his time in office.[1] Italiano worked an alliance with Camden City Democratic Chairman Angelo Errichetti to insulate him from Democratic opposition.[2]
Despite this, in 1971 the New Jersey Democratic Party made a concerted effort to try and defeat Italiano's re-election bid, initially seeking James Florio, then a member of the General Assembly, to run against him, however, Florio declined due to Italiano's support from Errichetti.[2] Despite this Italiano would only narrowly beat Thomas R. Bristow by a 50.7%-49.3% margin with just 697 votes separating the two.[2]
Following the Watergate scandal and the defeat of incumbent Republican governor William T. Cahill in the primaries, Italiano declined to seek re-election to a third term in 1973.[3] Instead, as one of his last acts in office, Cahill would appoint Italiano as a judge of the Camden County District Court.[4] The third district would be re-districted to become the 5th district, with John J. Horn succeeding Italiano.