Etanercept is a dimeric fusion protein consisting of the extracellular portion of tumor necrosis factor (TNF) p75 receptor and human IgG1 Fc fragment, which, similarly to the physiological soluble TNF receptor, is capable of binding TNF-α and lymphotoxin. The mechanism of action of etanercept in psoriatic disease and other approved indications is mediated by the neutralization of soluble TNF-α leading to a modulation of the immune response. Clinical trials have provided robust evidence supporting the sustained efficacy and safety of etanercept in psoriasis, as both intermittent and continuous therapy. The aim of this manuscript was to review the efficacy profile of etanercept in psoriasis according to the clinical experience gained by Italian dermatological centers and derived from the available publications on this topic. Everyday practice confirms that etanercept is a valuable and flexible therapeutic tool for the management of high-need psoriasis patients.