Through census employment data we analyze the evolving structure of the Italian cultural economy and highlights diverging spatial and organizational patterns of cultural production systems in urban and regional areas. Whilst large metropolitan areas remain the more important loci of cultural content production and consumption, craft-based sectors and creative systems of design have a tendency to locate in non-metropolitan centers. Based on the historical formation of manufacturing districts and on the emergence of Rome and Milan as “world cities”, the Italian cultural economy provides an interesting case study to analyze the geographical patterns of different cultural product industries. We extend previous literature on the geography of the cultural economy by offering new insights as to conditions in which metropolitan and rural areas emerge as leading centers of cultural production and creativity.