The incursion of bluetongue (BT) in Italy, in August 2000, caused heavy economic losses, partly due to the direct effect of the disease on the animals, but mostly due to indirect losses due to ruminant movement restrictions conducive to heavy losses to the cattle and sheep industry. To limit losses due to both disease and virus circulation, which was the cause of movement restrictions, the Italian Ministry of Health in May 2001 ordered the vaccination of animals of all domestic ruminant species in infected and "at risk" areas. The vaccination strategy derived from a risk assessment that suggested that the vaccination of all domestic ruminants could reduce both direct losses and virus circulation significantly. The different levels of vaccination coverage, achieved in the various regions of Italy, had clear consequences on the spread of both disease and infection. In regions where more than 80% of the target populations were vaccinated properly, the disease disappeared almost completely and virus circulation was significantly reduced, as documented by the serological surveillance system, after a single vaccination cycle. This led to a significant decrease in the areas subject to movement restrictions. Data generated by both field and controlled experiments contributed to modify the EU approach to BT and to some of the conclusions of the Third OIE International Symposium on Bluetongue that will probably lead to a modification of the Office International des Epizooties (OIE) standard.