Fusarium Head Blight is a devastating disease of wheat caused by a complex of Fusarium species producing a wide range of mycotoxins. Fusarium species occurrence is variable in different geographical areas and subjected to a continuous evolution in their distribution. A total of 141 durum wheat field samples were collected in different regions of Italy in three years, and analyzed for Fusarium species and related mycotoxin occurrence. Mycotoxin contamination varied according to year and geographical origin. The highest mycotoxin contamination was detected in 2014. Deoxynivalenol was detected with an average of 240 µg/kg only in Central and Northern Italy; and T-2 and HT-2 toxins with an average of 150 µg/kg in Southern Italy. Approximately 80% of samples from Southern Italy in 2013/2014 showed T-2 and HT-2 levels over the EU recommended limits. Fusarium graminearum occurred mostly in Northern Italy, while F. langsethiae occurred in Southern Italy. These data showed that a real mycotoxin risk related to Fusarium exists on the whole in Italy, but varies according with geographical areas and environmental conditions. Consistent monitoring of Fusarium species and related mycotoxin distribution on a long period is worthwhile to generate more accurate knowledge on Fusarium species profile and mycotoxins associated and better establish the climatic change impact on wheat Fusarium epidemiology.