Italy led 17-14 at halftime and a late try earned them a losing bonus point in their most competitive Six Nations performance against England - the only team they have never beaten in the competition.
England took a long time to find their groove and will be concerned over defensive lapses, but coach Steve Borthwick will be pleased with the performances of five debutants, not least man of the match back-rower Ethan Roots.
England's new-look squad contained only 12 of the 23 who lost the World Cup semi-final to South Africa, and they looked disorganised from the start, particularly defensively.
Italy, with new coach Gonzalo Quesada promising a more pragmatic approach after their disastrous World Cup, in contrast were cohesive and sharp from the start.
Tommaso Allan put them ahead with a penalty before Lorenzo Cannone sent Alessandro Garbisi clear for the opening try, albeit via what England felt was a forward pass.
England hit back when the livewire Tommy Freeman, showing the barnstorming running that earned him an international recall, broke through and offloaded for Elliot Daly to score.
Italy responded immediately, though, as England’s defence got into a hopeless mix-up to allow Allan all the space he needed to gallop under the posts.
FORD PENALTIES
Two George Ford penalties closed the gap to 17-14 at halftime, somewhat flattering for England.
The odds-on favourites finally edged ahead five minutes into the second half when scrumhalf Alex Mitchell showed great determination to squirm through two tackles and touched down.
Another Ford penalty stretched the lead as Italy struggled for any sort of foothold in the face of aggressive England blitz defence.
England sent on two more debutants in flyhalf Fin Smith and flanker Chandler Cunningham-South and when winger Immanuel Feyi-Waboso made it five, it was the most since Stuart Lancaster’s first game in charge in the opening game of the 2012 Six Nations - when Owen Farrell won his first cap.
England won an 80th-minute penalty that they could have popped over for a 30-17 win but they opted for a scrum and were penalised, allowing Italy to kick for a lineout and send Monty Ioane clear down the wing through a few soft tackles to earn Italy's bonus point.
Jamie George, in his first game as England captain, described the performance as a mixed bag.
"I would say I am really pleased with some of the endeavour. The boys dug in at times and I am pleased with the character we showed but there were a couple of runaway tries," the hooker said.
"There were some new faces in the squad, but the blueprint we played in the second half showed what we are more about.
"In terms of our efficiency there are some fixes we need to get right. The thing that pleased me the most is we tried things and that is what we have been focusing on."
Borthwick said there were positives to take from the performance.
"It looked clunky in bits," he said. "It looked like a team which only had three training sessions together.
"But a winning start with five debutants and the ability to be in a difficult position and find your way out of it is a massive positive," Borthwick added.
"You are always looking for change. There are certainly things to be improved and we got exposed by an Italian team that moves the ball well, but we will improve on that next week."
England host Wales next Saturday and Italy face the daunting prospect of a trip to Dublin on Sunday to face championship favourites Ireland, who beat France 38-17 in Paris on Friday
