Italy face failing to qualify for the World Cup for the first time since 1958 after substitute Jakob Johansson gave Sweden a 1-0 first-leg lead in their play-off encounter.
Questions over Gian Piero Ventura's abilities as head coach of the Azzurri must now be met with a decisive answer in Monday's return at San Siro after a disjointed display in Solna.
Watched on by the iconic Zlatan Ibrahimovic in the stands, Sweden's robust forward duo Marcus Berg and Ola Toivonen proved a handful for the unusually discomforted Leonardo Bonucci and Giorgio Chiellini in Italy's defence.
AEK Athens midfielder Johansson had not been on the field for four minutes as Albin Ekdal's replacement when Italy failed to deal with a long throw just after the hour and he beat Gianluigi Buffon via a deflection.
Matteo Darmian came closest to finding an equaliser when he was denied by the post but a tough task awaits in Milan, especially after influential midfielder Marco Verratti collected a booking to rule himself out of Ventura's date with destiny.
The tone was set for a bustling, frenetic opening inside the first minute when Toivonen caught Bonucci with an elbow. The AC Milan defender writhed on the floor and Berg received a booking for dissent as he did so.
RB Leipzig playmaker Emil Forsberg skied a fourth-minute free-kick – Bonucci tugging Berg to the floor to continue his inauspicious start - before Andrea Belotti headed Darmian's searching left-wing cross narrowly wide on Italy's first attack.
Toivonen than pulled a drive just past Buffon's right-hand post following cute work by Forsberg, who lifted wastefully off target again when the ball broke to him on the edge of the Italy box in the 25th minute.
Italy were struggling to gain a foothold in the contest and Verratti encapsulated their simmering frustration with an ill-judged challenge on Berg that brought a yellow card to rule him out of the second leg.
Buffon was forced to fling himself expertly at the feet of Toivonen after Chiellini became the latest of his old defensive lieutenants to err under pressure from Berg.
The visitors began the second half with greater conviction – Antonio Candreva's devilish cross from the right sewing confusion between Sweden goalkeeper Robin Olsen and captain Andreas Granqvist, almost forcing the latter into an own-goal.
As the hour approached, the teams were involved in an increasingly fractious contest, with Berg orchestrating much of the disquiet.
The Al Ain striker barged Chiellini to instigate a collision with Buffon before catching Daniele De Rossi with another of his wandering elbows.
Italy were increasingly irked as a collective and it was in this state that they fell behind.
Toivonen outmuscled Chiellini to get his head to Emil Krafth's long throw and Johansson, with his first meaningful contribution, smashed goalwards to see a telling deflection off Marco Parolo do the rest.
Ventura sent on Eder for the ineffective Belotti in a bid to force a reply, which almost arrived from an unlikely source – Manchester United wing-back Darmian clattering a thunderous drive against the post with Olsen rooted to the spot.
A convincing final rally failed to materialise, even with Lorenzo Insigne on in Verratti's place.
Ventura could do worse than trusting in-form Napoli attacker Insigne to salvage matters when the teams reconvene. If Italy do not escape, Antonio Conte's successor will surely see his reign end in ignominy.
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