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The essay deals with the impact of the COVID-19 pandemic on the relations between the State and the Regions in health matters. The study begins with the evaluation of these relations on the eve of the pandemic crisis and continues by examining the constants deriving from the interven-tions carried out during the pandemic, in order to assess if they are able to structurally affect the relations between the State and the Regions in this domain. This analysis shows that the State seeks to centralise, marginalising both the Regions and the Conference State-Regions, the latter being deprived of its key role in health governance before pandemic. The process of centralisation is strengthened by the Constitutional Court: the sentence n. 37 of 2021 extends the boundaries of the State exclusive legislative competence, according to article 117, second paragraph of the Constitution. Consequently, the centralisation of health governance during the pandemic looks likely to consolidate after the pandemic.
