Background & aims: Nutritional risk on admission to hospital, which turns out to be high in mostcountries, was investigated. However, when consulting the ‘‘malnutrition-mapping’’ in Europe, the lackof Italian data raises attention. Accordingly, we designed a multidisciplinary, cross-sectional survey: thePIMAI study (Project: Iatrogenic MAlnutrition in Italy).Methods: Patients were enrolled from 13 large (>400 beds) multidisciplinary hospitals. Randomlyselected adult (>18-year-old) patients were included according to a 4-strata model by gender and age(<65 and >65 years). Nutritional risk was assessed by the Nutritional Risk Screening 2002 tool.Results: A total of 1284 patients were evaluated. Overall prevalence of nutritional risk was 28.6% withsimilar distribution between sexes and higher rates in medical rather than in surgical departments(33.6% vs 22.8%; p < 0.0001). Risk prevalence was markedly heterogeneous among specialties, rangingbetween 4.8% (ophthalmology) and 62.5% (oncology units). Moreover, in adults aged 18–65 years theprevalence of ‘‘risk of malnutrition’’ was significantly lower than in those >65 years (18.3% vs 41.9%;p < 0.0001).Conclusions: The prevalence of nutritional risk on admission to hospital is high also in Italy. However, inpatients aged 18–65 years nutritional risk appears a less prevalent comorbidity, thus supporting the roleof age as an important determinant