Italy's victory marks its first at a U20 Women's World Cup, after group-stage exits in two prior appearances. The U.S. next plays Japan on Wednesday in a game where the Americans will likely need to take points to advance to the knockout stage.
The United States took the lead in the 18th minute when forward Micayla Johnson opened the scoring for the United States with an empty-net tap-in. Italy equalized five minutes before halftime, with Paola Fadda finishing the play after U.S. goalkeeper Caroline Birkel initially made a save.
Italy sealed the win in the 59th minute when Giada Pellegrino Cimo scored the game-winning goal after U.S. defender Ella Bard was dispossessed on the wing, and the ensuing cross went through the hands of U.S. goalkeeper Caroline Birkel. The U.S. pushed for an equalizer late but was denied when Sealey Strawn was called offside in stoppage time.
The U.S. will finish group play on Saturday against New Zealand, with the Americans needing to take points to advance to the knockout stage.